Measuring Adverse Cardiovascular Outcomes (MACE) in diabetic vs nondiabetic Primary PCI (PPCI) patients suffering from STEMI in PIC, Lahore

Authors

  • Kamran Dawood Ahmad Rehmatul lil Alameen Institute of Cardiology, Lahore
  • Khurram Shahzad Punjab Institute of Cardiology, Lahore
  • Rahat Naseem King Edward Medical University, Lahore
  • Mariam Tahir Siddiqi Gulab Devi Medical Complex, Lahore
  • Samra Yasmin Haque Punjab Institute of Cardiology, Lahore
  • Sajjad Ahmad Punjab Institute of Cardiology, Lahore

DOI:

https://doi.org/10.55958/jcvd.v19i1.127

Keywords:

Primary PCI, Acute STEMI, MACE.

Abstract

Abstract

Introduction:

All over the world, particularly in developing countries, Coronary Artery Diseases (CADs) are a major cause of significant morbidity and mortality. Primary PCI (PPCI) is the standard of emergency care in patients suffering from STEMI. The major cardiovascular outcomes (MACE) may be different in diabetic and nondiabetic patients.

Objective:

This article aims at comparing major adverse cardiovascular outcomes in diabetic and nondiabetic STEMI patients going through pPCI.

Study design:

Descriptive case series

Study setting:

Emergency Department, Punjab Institute of Cardiology (PIC), Lahore.

Methodology:

A total of 245 patients were included out of which 85 were diabetic and 160 were nondiabetic. Post-PPCI in-hospital outcomes were recorded: mortality, cerebrovascular accident, acute and subacute stent thrombosis, heart failure, acute kidney injury and arrhythmias.

Results:

With mean age of 50.3 ± 9.7 years; mean BMI of 28.0 ± 2.0 kg/m2, risk factors included hypertension (73), family history of IHD (23) and smoking (81). Post-PPCI in hospital outcomes in 85 diabetics were as follows: mortality 0, heart failure in 1 (1.18%), acute stent thrombosis 0; acute kidney injury in 8 patients (9.41%). Among 160 nondiabetic patients, post PPCI outcomes were as follows: mortality 2 (1.25%), heart failure 4 (2.5%), acute stent thrombosis 1 (0.6%) and acute kidney injury 6 (3.75%). The only significant association among PPCI following STEMI and in-hospital outcomes was with acute kidney injury (P = 0.069).

Conclusion:

For acute STEMI, following the primary percutaneous intervention (PPCI), results among diabetic and nondiabetic patients seem to be favorable in terms of major undesirable outcomes and possible to achieve in PIC, Lahore. PPCI is associated with larger success rate, low mortality rate and complication rates. The hospital's experiences and results can be very valuable in establishing PPCI networks in our nation.

Keywords:

Primary PCI, Acute STEMI, MACE.

Author Biographies

Khurram Shahzad, Punjab Institute of Cardiology, Lahore

Assistant Professor of Cardiology

Rahat Naseem, King Edward Medical University, Lahore

Assistant Professor Physiology 

Mariam Tahir Siddiqi, Gulab Devi Medical Complex, Lahore

Senior Registrar Cardiology

Samra Yasmin Haque, Punjab Institute of Cardiology, Lahore

Assistant Professor of Cardiology

Sajjad Ahmad, Punjab Institute of Cardiology, Lahore

Professor of Cardiology

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Published

2023-04-19

Issue

Section

Articles