scholarly journals Comparative Effect of Statin Intensity Between Prediabetes and Type 2 Diabetes Mellitus After Implanting Newer-generation Drug-eluting Stents in Korean Acute Myocardial Infarction Patients: a Retrospective Observational Study

2020 ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Clinical Outcomes ◽  
High Intensity ◽  
Moderate Intensity ◽  
Drug Eluting Stents ◽  
Repeat Revascularization ◽  
Drug Eluting

Abstract Background: Comparative studies regarding the long-term clinical outcomes of statin intensity between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM), after successful implantation of newer-generation drug-eluting stents (DES) with statin treatment, are limited. We compared the 2-year clinical outcomes between these patients. Methods: A total of 11612 AMI patients were classified as statin users (n = 9893) and non-users (n = 1719). Thereafter, statin users were further divided into high-intensity (n = 2984) or low-moderate-intensity statin (n = 6909) treatment groups. Those in these two groups were further classified into patients with normoglycemia, prediabetes, and T2DM. The major outcomes were the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization. Results: After adjusting for both high-intensity and low-moderate-intensity statin users, the cumulative incidences of MACE (p = 0.737, p = 0.062, respectively), all-cause death, Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. In the total study population, both high-intensity and low-moderate-intensity statin treatments showed comparable results. However, the beneficial effects of high-intensity compared to low-moderate-intensity statin therapy were more apparent in the normoglycemia group than hyperglycemia group, as it reduced the cumulative incidences of MACE (aHR: 1.903; 95% CI: 1.203-3.010; p = 0.006) and any repeat revascularization (aHR: 3.248; 95% CI: 1.539-6.854; p = 0.002). Conclusions: In this retrospective registry study, prediabetes and T2DM groups showed comparable clinical outcomes, after administering both high-intensity and low-moderate-intensity statin treatments. Trial registration: Retrospectively registered

scholarly journals Comparative effect of statin intensity between prediabetes and type 2 diabetes mellitus after implanting newer-generation drug-eluting stents in Korean acute myocardial infarction patients: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Clinical Outcomes ◽  
High Intensity ◽  
Moderate Intensity ◽  
Drug Eluting Stents ◽  
Repeat Revascularization ◽  
Drug Eluting

Abstract Background Comparative studies regarding the long-term clinical outcomes of statin intensity between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM), after successful implantation of newer-generation drug-eluting stents (DES) with statin treatment, are limited. We compared the 2-year clinical outcomes between these patients. Methods A total of 11,612 AMI patients were classified as statin users (n = 9893) and non-users (n = 1719). Thereafter, statin users were further divided into high-intensity (n = 2984) or low-moderate-intensity statin (n = 6909) treatment groups. Those in these two groups were further classified into patients with normoglycemia, prediabetes, and T2DM. The major outcomes were the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization. Results After adjusting for both high-intensity and low-moderate-intensity statin users, the cumulative incidences of MACE (p = 0.737, p = 0.062, respectively), all-cause death, Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. In the total study population, both high-intensity and low-moderate-intensity statin treatments showed comparable results. However, in the patients who enrolled after October 2012, the cumulative incidences of MACE (aHR 1.533; 95% CI 1.144–2.053; p = 0.004) and any repeat revascularization (aHR, 1.587; 95% CI 1.026–2.456; p = 0.038) were significantly lower in high-intensity statin users than in low-moderate intensity statin users. The beneficial effects of high-intensity compared to low-moderate-intensity statin therapy were more apparent in the normoglycemia group than hyperglycemia group, as it reduced the cumulative incidences of MACE (aHR 1.903; 95% CI 1.203–3.010; p = 0.006) and any repeat revascularization (aHR 3.248; 95% CI 1.539–6.854; p = 0.002). Conclusions In this retrospective registry study, prediabetes and T2DM groups showed comparable clinical outcomes, after administering both high-intensity and low-moderate-intensity statin treatments. However, these results are likely to be clearly proved by further studies, especially in patients with AMI who are being treated in contemporary practice. Trial registration Retrospectively registered.

scholarly journals Outcomes between prediabetes and type 2 diabetes mellitus in older adults with acute myocardial infarction in the era of newer-generation drug-eluting stents: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Secondary Outcome ◽  
Drug Eluting Stents ◽  
Drug Eluting

Abstract Background The comparative clinical outcomes between prediabetes and type 2 diabetes mellitus (T2DM) in older adults with AMI in the era of newer-generation drug-eluting stents (DES) are limited. We investigated the 2-year clinical outcomes of these patients. Methods A total of 5492 AMI patients aged ≥65 years were classified into three groups according to their glycemic status: normoglycemia (group A: 1193), prediabetes (group B: 1696), and T2DM (group C: 2603). The primary outcome was the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization. The secondary outcome was stent thrombosis (ST). Results The primary and secondary outcomes cumulative incidences were similar between the prediabetes and T2DM groups. In both the prediabetes and T2DM groups, the cumulative incidences of MACE (adjusted hazard ratio [aHR]: 1.373; p = 0.020 and aHR: 1.479; p = 0.002, respectively) and all-cause death or MI (aHR: 1.436; p = 0.022 and aHR: 1.647; p = 0.001, respectively) were significantly higher than those in the normoglycemia group. Additionally, the cumulative incidence of all-cause death in the T2DM group was significantly higher than that in the normoglycemia group (aHR, 1.666; p = 0.003). Conclusions In this retrospective study, despite the 2-year clinical outcomes of the patients with prediabetes and T2DM in the older adults were worse than those in the normoglycemia group; they were similar between the prediabetes and T2DM groups. Hence, comparable treatment strategies should be strengthened between prediabetes and T2DM in older adults with AMI. Trial registration Retrospectively registered.

scholarly journals The Expression of Liver Metabolic Enzymes AMPKα1, AMPKα2, and PGC-1α due to Exercise in Type-2 Diabetes Mellitus Rat Model

2020 ◽  
Vol 8 (A) ◽  
pp. 629-632
Author(s):  
Yetty Machrina ◽  
Yunita Sari Pane ◽  
Dharma Lindarto
Keyword(s):  
Gene Expression ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Rat Model ◽  
High Intensity ◽  
Metabolic Enzymes ◽  
Moderate Intensity ◽  
Metabolism Enzymes

BACKGROUND: AMP-activated protein kinase (AMPK) and PGC-1α were crucial metabolism enzymes not only in the skeletal muscles but also in the liver. Exercise can modify metabolic enzymes to improve insulin resistance. AIM: The aim of this study was to analyze the expression of mRNA liver metabolic enzymes gene, that is, AMPKα1, AMPKα2, and PGC-1α in different types and intensities of exercise. METHODS: Healthy male Wistar rats aged 8 weeks in 150–180 g body weight were given a combination of high fat diet for five weeks and low doses of streptozotocin (30 mg/kgbw and 45 mg/kgbw in 0.1 citrate buffer pH 4,5) to develop type 2 diabetes mellitus (T2DM) rat model. Animals then were divided into five groups: One group was sedentary, and four groups were forced to run on the treadmill 3 times/week, 30 min each season, for 8 weeks. mRNA gene expression of AMPKα1, AMPKα2, and PGC-1α was determined with real-time PCR. RESULTS: The results showed that expression of mRNA AMPKα1 in treatment groups was elevated than control and the much expression was showed in continuous types. The expression of mRNA AMPKα2 and PGC-1 α was declined in treatment group which little expression was showed in high intensity for AMPKα2 and moderate intensity for PGC-1 α. Base on type and exercise intensity, mRNA AMPKα1 gene expression much in moderate continuous, mRNA AMPKα2 gene expression higher in high intensity, both continuous and interval training, whereas mRNA PGC-1α gene expression higher in interval groups. CONCLUSION: Various types of aerobic exercises with moderate-vigorous intensities gave different impact to mRNA liver metabolic enzyme genes.

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