Outcomes of primary percutaneous coronary intervention in a population of Iranian patients with myocardial infarction, according to the history of diabetes from 2018 till 2021

Primary percutaneous coronary intervention (PPCI) is the mainstay treatment for patients with ST-Elevation Myocardial Infarction (STEMI). However, depending on patient characteristics, this procedure may be associated with major adverse cardiovascular events (MACE). Diabetes mellitus has consistently been identified as a significant risk factor for adverse outcomes. In this study, we also evaluated the impact of other clinical factors; including hypertension, chronic kidney disease (CKD) and past medical history on MACE. In this retrospective cohort study, 722 patients who underwent PPCI at Sina Hospital between 2018 and 2021 were enrolled. Participants were categorized into two equal groups: 361 with diabetes and 361 without. Demographic information, PPCI-related characteristics, and clinical variables such as blood pressure, lipid profile, and CKD status were collected. Major outcomes, including myocardial infarction (MI), cerebrovascular accident (CVA), and mortality, were assessed in both the short term (within 24 hours post-PPCI) and long term (six months post-PPCI). Diabetic patients were significantly older (mean age 61.5 vs. 57.93 years) and had a higher proportion of females. They also had a greater history of MI and prior PPCI. Overall mortality after PPCI was significantly higher in diabetic patients, smokers and those with both diabetes and hypertension. Long-term mortality was notably associated with the presence of CKD. Lower admission blood glucose levels were linked to increased CVA incidence, while recurrent MI was more common among patients with reduced ejection fraction. Age was positively correlated with the occurrence of MACE.