Restricted accessResearch articleFirst published online 2023-3
Effects of Hypertension on Two-Year Outcomes According to Glycemic Status in Patients With Acute Myocardial Infarction Receiving Newer-Generation Drug-Eluting Stents
The effects of hypertension on long-term outcomes according to glycemic status in patients with acute myocardial infarction (AMI) after successful implantation of newer-generation drug-eluting stents (DES) have not been fully investigated. In this retrospective cohort study, a total of 11,911 patients were classified into 6 groups according to their glycemic status and presence or absence of hypertension. The major outcome was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any revascularization. In patients without hypertension, the major outcomes were similar between the normoglycemia and prediabetes groups. However, MACE, all-cause death, cardiac death (CD), Re-MI rates were higher in patients with type 2 diabetes mellitus (T2DM) than in normoglycemic patients. Additionally, Re-MI was higher in patients with T2DM than in prediabetic patients. In patients with hypertension, although the major outcomes were similar between the prediabetes and T2DM groups, in both the prediabetes and T2DM groups, MACE, all-cause death, and CD rates were higher than those in the normoglycemia group. During a 2-year follow-up, the comparable harmful effects of hypertension in patients with AMI and prediabetes or T2DM were observed. Effective blood pressure and glucose control should be strengthened to reduce mortality in these patients.
RosendorffCLacklandDTAllisonM, et al.Treatment of hypertension in patients with coronary artery disease: a scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Circulation. 2015;131:e435–e470.
2.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998;317:703-713.
3.
HanssonLZanchettiACarruthersSG, et al.Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet. 1998;351:1755-1762.
4.
ZoungasSde GalanBENinomiyaT, et al.Combined effects of routine blood pressure lowering and intensive glucose control on macrovascular and microvascular outcomes in patients with type 2 diabetes. Diabetes Care. 2009;32:2068-2074.
5.
KimYHHerA-YJeongMH, et al.Which is the worst risk factor for the long‐term clinical outcome? Comparison of long‐term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation. J Diabetes. 2020;12:119-133.
6.
EmdinCARahimiKNealBCallenderTPerkovicVPatelA. Blood pressure lowering in type 2 diabetes. JAMA. 2015;313:603-615.
7.
XieXAtkinsELvJ, et al.Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016387:435-443.
8.
American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2016;42(suppl 1):S13-S22.
9.
HuangYCaiXMaiWLiMHuY. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016;355:i5953.
10.
QiuMShenWSongX, et al. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus. Hypertension2015;65:525-530.
11.
LiuH-HCaoY-XLiS, et al.Impacts of Prediabetes mellitus alone or plus hypertension on the coronary severity and cardiovascular outcomes. Hypertension. 2018;71:1039-1046.
12.
KimYHHerA-YJeongMH, et al.Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients. Sci Rep. 2021;11:9364.
13.
LeeSAChoSJJeongMH, et al.Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients. Diabetes Care. 2014;37:2366-2373.
14.
KimJHChaeS-COhDJ, et al.Multicenter cohort study of acute myocardial infarction in korea - interim analysis of the Korea acute myocardial infarction registry-national institutes of health registry. Circ J. 2016;80:1427-1436.
15.
GrechED. Percutaneous coronary intervention. II: The procedure. BMJ. 2003;326:1137-1140.
16.
ChenKYRhaSWLiYJ, et al.Triple versus dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Circulation. 2009;119:32073214.
17.
GaoWZhangQGeHGuoYZhouZ. Efficacy and safety of triple antiplatelet therapy in obese patients undergoing stent implantation. Angiology. 2013;64:554-558.
18.
WilliamsBManciaGSpieringW, et al.2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens2018;36:2284-2309.
19.
KokMMvon BirgelenCSattarN, et al.Prediabetes and its impact on clinical outcome after coronary intervention in a broad patient population. EuroIntervention. 2018;14:e1049-e1056.
20.
IbanezBJamesSAgewallS, et al.2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39:119-177.
21.
RoffiMPatronoCColletJ-P, et al.2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016;37:267-315.
22.
O'GaraPTKushnerFGAscheimDD, et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127:529-555.
23.
AmsterdamEAWengerNKBrindisRG, et al.2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the american college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol.2014;64:e139-228.
24.
KimYHHerA-YJeongMH, et al.Impact of renin-angiotensin system inhibitors on long-term clinical outcomes in patients with acute myocardial infarction treated with successful percutaneous coronary intervention with drug-eluting stents: Comparison between STEMI and NSTEMI. Atherosclerosis. 2019;280:166-173.
25.
Hypertension in Diabetes Study (HDS): I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications. J Hypertens. 1993;11:309-317.
26.
RizviAA. Addressing hypertension in the patient with type 2 diabetes mellitus: pathogenesis, goals, and therapeutic approach. European medical journal. Diabetes. 2017;5:84-92.
27.
HuangZChenCLiSKongFShanPHuangW. Serum markers of endothelial dysfunction and inflammation increase in hypertension with prediabetes mellitus. Genet Test Mol Biomarkers. 2016;20:322-327.
28.
FerranniniEBuzzigoliGBonadonnaR, et al.Insulin resistance in essential hypertension. N Engl J Med. 1987;317:350-357.
29.
GiaccoFBrownleeM. Oxidative stress and diabetic complications. Circ Res. 2010;107:1058-1070.
30.
NataliATaddeiSGalvanAQ, et al.Insulin sensitivity, vascular reactivity, and clamp-induced vasodilatation in essential hypertension. Circulation. 1997;96:849-855.
31.
NataliAToschiEBaldewegS, et al.Clustering of insulin resistance with vascular dysfunction and low-grade inflammation in type 2 diabetes. Diabetes. 2006;55:1133-1140.
32.
von BirgelenCKokMMSattarN, et al."Silent" diabetes and clinical outcome after treatment with contemporary drug-eluting stents. JACC Cardiovasc Interv. 2018;11:448-459.
33.
DaurizMTargherGTemporelliPL, et al.Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post-Hoc Analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) Trial. J Am Heart Assoc. 2017;6:e005156.
34.
GiraldezRRClareRMLopesRD, et al.Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome. Am Heart J. 2013;165:918-925.
35.
KimYHHerA-YJeongMH, et al.Effects of prediabetes on long-term clinical outcomes of patients with acute myocardial infarction who underwent PCI using new-generation drug-eluting stents. Diabetes Res Clin Pract. 2020;160:107994.
36.
HubbardDColantonioLDTannerRM, et al.Prediabetes and risk for cardiovascular disease by hypertension status in black adults: the jackson heart study. Diabetes Care. 2019;42:2322-2329.
37.
van der HeijdenAAWAvan’t RietEBotSDM, et al.Risk of a recurrent cardiovascular event in individuals with type 2 diabetes or intermediate hyperglycemia. Diabetes Care. 2013;36:3498-3502.
38.
KimYHHerA-YJeongMH, et al.Effect of renin-angiotensin system inhibitors on major clinical outcomes in patients with acute myocardial infarction and prediabetes or diabetes after successful implantation of newer-generation drug-eluting stents. J Diabetes Complicat. 2020;34:107574.
39.
DeedwaniaPCAhmedMIFellerMA, et al.Impact of diabetes mellitus on outcomes in patients with acute myocardial infarction and systolic heart failure. Eur J Heart Fail. 2011;13:551-559.
40.
SemenkovichCF. We know more than we can tell about diabetes and vascular disease: The 2016 edwin bierman award lecture. Diabetes. 2017;66:1735-1741.
41.
KimYHHerA-YRhaSW, et al.Five-year major clinical outcomes between first-generation and second-generation drug-eluting stents in acute myocardial infarction patients underwent percutaneous coronary intervention. Journal of geriatric cardiology: JGC. 2018;15:523-533.
42.
ArodaVRBainSCCariouB, et al.Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol. 2017;5:355-366.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
