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    Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration

    Access Status
    Fulltext not available
    Authors
    Wong, M.Y.Z.
    Yap, J.J.L.
    Chih, Hui Jun
    Yan, B.P.Y.
    Fong, A.Y.Y.
    Beltrame, J.F.
    Wijaya, I.P.
    Nguyen, H.T.T.
    Brennan, A.L.
    Reid, Christopher
    Yeo, K.K.
    Date
    2023
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Wong, M.Y.Z. and Yap, J.J.L. and Chih, H.J. and Yan, B.P.Y. and Fong, A.Y.Y. and Beltrame, J.F. and Wijaya, I.P. et al. 2023. Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration. International Journal of Cardiology. 371: pp. 84-91.
    Source Title
    International Journal of Cardiology
    DOI
    10.1016/j.ijcard.2022.10.001
    ISSN
    0167-5273
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Population Health
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/546272
    http://purl.org/au-research/grants/nhmrc/1136372
    URI
    http://hdl.handle.net/20.500.11937/93769
    Collection
    • Curtin Research Publications
    Abstract

    Background: Diabetes is associated with poorer outcomes and increased complication rates in STEMI patients undergoing percutaneous coronary intervention (PCI). Data are notably lacking in the Asia-Pacific region. We report the overall association of Diabetes with clinical characteristics and outcomes in STEMI patients undergoing PCI across the Asia-Pacific, with a particular focus on regional differences. Methodology: The Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration consists of data from various PCI registries across Australia, Hong Kong, Singapore, Malaysia, Indonesia and Vietnam. Clinical characteristics, lesion characteristics, and outcomes were provided for STEMI patients. Key outcomes included 30-day overall mortality and major adverse cardiovascular events (MACE). Results: A total of 12,144 STEMI patients (mean(SD) age 59.3(12.3)) were included, of which 3912 (32.2%) had diabetes. Patients with diabetes were likely to have a higher baseline risk profile, poorer clinical presentation, and more complex lesion patterns (all p < 0.05). Across all regions, patients with diabetes had a higher rate of 30-day mortality and MACE (all p < 0.05). After multivariable adjustment, diabetes was significantly associated with both increased 30-day mortality (9.6%vs 5.5%, OR 1.79 [95% CI 1.40–2.30]) and MACE (13.3% vs 8.6%, R 1.73 [1.44–2.08]). The association between diabetes and 30-day MACE varied by region (pinteraction = 0.041), with the association (OR) ranging from 1.34 [1.08–1.67] in Malaysia, to 2.39 [1.66–3.45] in Singapore. Conclusions: Diabetes portends poorer clinical outcomes in STEMI patients undergoing PCI in the Asia-Pacific with regional variations noted. The development of effective preventative measures and interventional strategies targetted at this high-risk group is crucial.

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