Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration
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 outcome...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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2023
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| Online Access: | http://purl.org/au-research/grants/nhmrc/546272 http://hdl.handle.net/20.500.11937/93769 |
| _version_ | 1848765784932745216 |
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| author | 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. |
| author_facet | 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. |
| author_sort | Wong, M.Y.Z. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:40:46Z |
| format | Journal Article |
| id | curtin-20.500.11937-93769 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:40:46Z |
| publishDate | 2023 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937692024-01-10T02:50:19Z Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration 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. Asia-Pacific Diabetes Percutaneous coronary intervention Regional differences STEMI Humans Middle Aged Percutaneous Coronary Intervention Risk Factors Treatment Outcome ST Elevation Myocardial Infarction Diabetes Mellitus Hong Kong Humans Diabetes Mellitus Treatment Outcome Risk Factors Middle Aged Hong Kong Percutaneous Coronary Intervention ST Elevation Myocardial Infarction 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. 2023 Journal Article http://hdl.handle.net/20.500.11937/93769 10.1016/j.ijcard.2022.10.001 eng http://purl.org/au-research/grants/nhmrc/546272 http://purl.org/au-research/grants/nhmrc/1136372 restricted |
| spellingShingle | Asia-Pacific Diabetes Percutaneous coronary intervention Regional differences STEMI Humans Middle Aged Percutaneous Coronary Intervention Risk Factors Treatment Outcome ST Elevation Myocardial Infarction Diabetes Mellitus Hong Kong Humans Diabetes Mellitus Treatment Outcome Risk Factors Middle Aged Hong Kong Percutaneous Coronary Intervention ST Elevation Myocardial Infarction 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. Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title | Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title_full | Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title_fullStr | Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title_full_unstemmed | Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title_short | Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes: The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration |
| title_sort | regional differences in percutaneous coronary intervention outcomes in stemi patients with diabetes: the asia-pacific evaluation of cardiovascular therapies (aspect) collaboration |
| topic | Asia-Pacific Diabetes Percutaneous coronary intervention Regional differences STEMI Humans Middle Aged Percutaneous Coronary Intervention Risk Factors Treatment Outcome ST Elevation Myocardial Infarction Diabetes Mellitus Hong Kong Humans Diabetes Mellitus Treatment Outcome Risk Factors Middle Aged Hong Kong Percutaneous Coronary Intervention ST Elevation Myocardial Infarction |
| url | http://purl.org/au-research/grants/nhmrc/546272 http://purl.org/au-research/grants/nhmrc/546272 http://hdl.handle.net/20.500.11937/93769 |