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Long-term impact of diabetes in patients with ST-segment elevation myocardial infarction: Insights from the EXAMINATION randomized trial

Catheterization and Cardiovascular Interventions Mar 27, 2019

Jimenez-Quevedo P, et al. - In this posthoc subanalysis of the EXAMINATION trial, researchers compared 5-year outcomes between 258 diabetics vs 1,239 nondiabetics with ST-segment elevation myocardial infarction (STEMI) who received treatment with a second-generation drug-eluting stent, to determine the long term effect of diabetes in STEMI patients. In the trial, 1,497 patients were included, of whom 137 diabetics received everolimus-eluting stent (EES) and 121 were treated with bare-metal stent (BMS), whereas, 613 nondiabetics received EES and 626 received BMS. Up to 5-years, they assessed patient-oriented combined endpoint (POCE), including all-cause death, any MI or any revascularization, as well as other clinical parameters. Findings revealed worse clinical outcomes post-STEMI among diabetics vs nondiabetics, these worse outcomes were essentially attributed to atherosclerosis progression. Diabetics treated with EES demonstrated no attenuation in the rate of POCE at 5-years, however, had reduced revascularization need compared with BMS.
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