50 Decembar 2015. | Broj 2 | Izdanje 66 Medicinski podmladak Originalni radovi LONG-TERM MORTALITY AFTER PRIMARY PCI FOR STEMI IN PATIENTS WITH INSULIN-DEPENDENT DIABETES MELLITUS Petar Zlatanović 1 , Stefan Zaharijev 1 , Goran Stanković 2 1 Faculty of Medicine, University of Belgrade, Serbia 2 Mentor: Cardiology Clinic, Clinical Center of Serbia Contact e-mail: petarzlatanovic@yahoo.com Sažetak Uvod: Primarna PCI (pPCI) je zlatni standard u lečenju bolesnika sa akutnim infarktom miokarda (AIM) sa ST elevacijom (STEMI). Cilj: Cilj ove studije je da ispita uticaj dijabetičnog statusa na prijemu na petogodišnje preživljavanje kod pacijenata sa STEMI lečenih pPCI. Materijal i metode: Konsekutivni podaci za 2087 pacijenata primljenih u periodu od 1. januara 2009. do 31. decembra 2010. godine sa dijagnozom akutnog STEMI su prikupljeni iz elektronske baze podataka sale za kateterizaciju klinike za kardiologiju KCS. Pacijenti su podeljeni u 3 grupe: bez diabetes mellitusa (DM), bole- snici sa DM koji nisu na insulinskoj terapiji - NIDDM (non-insulin dependent diabetes mellitus), bolesnici sa DM koji su na insulinskoj terapiji - IDDM (insulin de- pendent diabetes mellitus). Rezultat: 1664 (79,7%) nije imalo DM, 98 (4,7%) je imalo IDDM, a 325 (15,6%) je imalo NIDDM. Pos- tojala je statistički značajna razlika u stopi mortaliteta između tri grupe nakon 30 dana, godinu dana i 5 godina od intervencije, a najviša stopa je zabeležna kod IDDM bolesnika, zatim u grupi NIDDM i najniža kod bolesni- ka bez DM (15,3% vs 8,3% vs 5,9%, p < 0,001 nakon 30 dana; 21,4% vs 15,4% vs 10,9%, p < 0,001 nakon godinu dana; 32,7% vs 24,3% vs 18,0% p < 0,001 nakon 5 godina). Takođe, postojala je visoko statistički značajna razlika u stopi petogodišnjeg mortaliteta između pacijenata sa i bez DM (26,2% vs 17,6%, p < 0,001). IDDM je bio ne- zavisan prediktor petogodišnjeg mortaliteta (HR=1,58, 95% CI 1,07-2,32, p = 0,02), dok NIDDM nije dostigao statističku značajnost (HR = 1,24, 95% CI 0,95-1,63, p = 0,12). Zaključak: Kod bolesnika sa DM postoji po- višen rizik od smrtnosti u kratkoročnom i dugoročnom praćenju nakon pPCI. Insulin-zavisan diabetes je neza- visan prediktor višeg petogodišnjeg mortliteta. Ključne reči: DM, IDDM, NIDDM, STEMI, pPCI Abstract Introduction: Primary PCI (pPCI) is the gold standard in the treatment of patients with acute myocar- dial infarction (AMI) with ST elevation (STEMI). Aim: Te purpose of this study is to evaluate the infuence of diabetic status upon arrival at fve year sur- vival in patients with STEMI that were treated with pPCI. Material and methods: Consecutive data for 2087 patients admitted in the period from 1 st of January 2009. to 31 st of December 2010. with diagnosis of acute STEMI were collected from catheterisation laboratory cardiolo- gy clinic CCS electronic database. Patients were divid- ed into 3 groups: those without diabetes mellitus (DM), IDDM (insulin dependent diabetes mellitus), NIDDM (non-insulin dependent diabetes mellitus). Results: 1664 patients (79.7%) did not have DM, 98 (4.7%) had IDDM and 325 (15.6%) had NIDDM. Tere was a statistically signifcant diference in mortal- ity rate among three groups afer 30 days, one year and fve years afer intervention, and the highest rates were recorded at the IDDM patients, then at the NIDDM and the lowest in patients without DM (15.3% vs 8.3% vs 5.9 %, p < 0.001 afer 30 days; 21.4% vs 15.4% vs 10.9%, p < 0.001 afer one year and 32.7% vs 24.3% vs 18%, p < 0.001 afer 5 years). Also, there was a highly statisti- cally signifcant diference in fve-year mortality rate be- tween patients with and without DM (26.2 % vs 17.6%, p < 0.001). IDDM was a independent factor when it comes to predicting fve-year mortality (HR = 1.58, 95% CI 1.07-2.32, p = 0.02) whereas NIDDM was not (HR = 1.24, 95% CI 0.95-1.63, p = 0.12). Conclusion: Diabetic patients had an increased risk of mortality in the short and long-term follow-up afer pPCI. Insulin-dependent was a single predicting factor afer fve year follow-up. Key words: DM, IDDM, NIDDM, STEMI, pPCI