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Prognostic significance of inflammatory biomarkers in diabetic and non-diabetic patients with STEMI, treated with primary percutaneous coronary intervention

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Title: Prognostic significance of inflammatory biomarkers in diabetic and non-diabetic patients with STEMI, treated with primary percutaneous coronary intervention
Authors: Milić Veljko, Džudović Boris, Obradović Slobodan
Source: Vojnosanitetski Pregled, Vol 76, Iss 10, Pp 979-984 (2019)
Publisher Information: Military Health Department, Ministry of Defance, Serbia, 2019.
Publication Year: 2019
Collection: LCC:Medicine (General)
Subject Terms: biomarkers, c-reactive protein, diabetes mellitus, fibrinogen, mortality, percutaneous coronary intervention, prognosis, st elevation myocardial infarction, Medicine (General), R5-920
More Details: Background/Aim. Although the prognostic significance of inflammatory biomarkers, C-reactive protein (CRP) and fibrinogen, in the patients with the ST-segment elevation myocardial infarction (STEMI) is already known, the specific difference between such patients according to diabetic status remains unknown. Methods. The study was conducted in a single tertiary center. The values of CRP and fibrinogen were measured during the first 48 h in consecutive patients with first STEMI treated with primary percutaneous coronary intervention (pPCI). The patients were divided into two groups: with diabetes and without diabetes. The aim of this study was to determine a prognostic significance of maximal values of these two inflammatory biomarkers for in-hospital and six-month mortality in these two groups. Results. Among 475 patients, 126 (26.5%) were with diabetes and 349 (73.5%) were without diabetes. The patients with diabetes had significantly higher median values of CRP and fibrinogen compared to the nondiabetic patients [29.6 (10.4–91.8) mg/L vs 22.4 (9.79–49.2) mg/L, p = 0.046 and 4.7 (3.6–6.3) g/L vs 4.3 (3.6–5.4) g/L, p = 0.026, respectively]. However, the multivariate survival analysis using the Cox regression model showed that in the nondiabetic STEMI patients CRP and fibrinogen had significant prognostic value for in-hospital mortality [hazard ratio (HR) = 1.013, 95% confidence interval (CI) (1.004–1.022), p = 0.004; HR = 1.529 (1.023–2.287), p = 0.039, respectively]. Regarding six-month mortality, no significant difference was achieved. Overall survival was the lowest in the fourth quartile of CRP in the patients without diabetes. Conclusion. The higher values of CRP are the significant independent predictor of in-hospital and overall mortality in the STEMI patients without diabetes treated with primary PCI. Fibrinogen can also be used as an additional prognostic inflammatory biomarker for in-hospital mortality in the non-diabetics with STEMI.
Document Type: article
File Description: electronic resource
Language: English
Serbian
ISSN: 0042-8450
2406-0720
Relation: https://doaj.org/toc/0042-8450; https://doaj.org/toc/2406-0720
DOI: 10.2298/VSP170905175M
Access URL: https://doaj.org/article/755c0f1276eb43228195bfb9853beeb9
Accession Number: edsdoj.755c0f1276eb43228195bfb9853beeb9
Database: Directory of Open Access Journals
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  Data: Prognostic significance of inflammatory biomarkers in diabetic and non-diabetic patients with STEMI, treated with primary percutaneous coronary intervention
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  Data: <searchLink fieldCode="AR" term="%22Milić+Veljko%22">Milić Veljko</searchLink><br /><searchLink fieldCode="AR" term="%22Džudović+Boris%22">Džudović Boris</searchLink><br /><searchLink fieldCode="AR" term="%22Obradović+Slobodan%22">Obradović Slobodan</searchLink>
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  Data: Vojnosanitetski Pregled, Vol 76, Iss 10, Pp 979-984 (2019)
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  Data: Military Health Department, Ministry of Defance, Serbia, 2019.
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  Data: 2019
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  Data: LCC:Medicine (General)
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  Data: <searchLink fieldCode="DE" term="%22biomarkers%22">biomarkers</searchLink><br /><searchLink fieldCode="DE" term="%22c-reactive+protein%22">c-reactive protein</searchLink><br /><searchLink fieldCode="DE" term="%22diabetes+mellitus%22">diabetes mellitus</searchLink><br /><searchLink fieldCode="DE" term="%22fibrinogen%22">fibrinogen</searchLink><br /><searchLink fieldCode="DE" term="%22mortality%22">mortality</searchLink><br /><searchLink fieldCode="DE" term="%22percutaneous+coronary+intervention%22">percutaneous coronary intervention</searchLink><br /><searchLink fieldCode="DE" term="%22prognosis%22">prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22st+elevation+myocardial+infarction%22">st elevation myocardial infarction</searchLink><br /><searchLink fieldCode="DE" term="%22Medicine+%28General%29%22">Medicine (General)</searchLink><br /><searchLink fieldCode="DE" term="%22R5-920%22">R5-920</searchLink>
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  Label: Description
  Group: Ab
  Data: Background/Aim. Although the prognostic significance of inflammatory biomarkers, C-reactive protein (CRP) and fibrinogen, in the patients with the ST-segment elevation myocardial infarction (STEMI) is already known, the specific difference between such patients according to diabetic status remains unknown. Methods. The study was conducted in a single tertiary center. The values of CRP and fibrinogen were measured during the first 48 h in consecutive patients with first STEMI treated with primary percutaneous coronary intervention (pPCI). The patients were divided into two groups: with diabetes and without diabetes. The aim of this study was to determine a prognostic significance of maximal values of these two inflammatory biomarkers for in-hospital and six-month mortality in these two groups. Results. Among 475 patients, 126 (26.5%) were with diabetes and 349 (73.5%) were without diabetes. The patients with diabetes had significantly higher median values of CRP and fibrinogen compared to the nondiabetic patients [29.6 (10.4–91.8) mg/L vs 22.4 (9.79–49.2) mg/L, p = 0.046 and 4.7 (3.6–6.3) g/L vs 4.3 (3.6–5.4) g/L, p = 0.026, respectively]. However, the multivariate survival analysis using the Cox regression model showed that in the nondiabetic STEMI patients CRP and fibrinogen had significant prognostic value for in-hospital mortality [hazard ratio (HR) = 1.013, 95% confidence interval (CI) (1.004–1.022), p = 0.004; HR = 1.529 (1.023–2.287), p = 0.039, respectively]. Regarding six-month mortality, no significant difference was achieved. Overall survival was the lowest in the fourth quartile of CRP in the patients without diabetes. Conclusion. The higher values of CRP are the significant independent predictor of in-hospital and overall mortality in the STEMI patients without diabetes treated with primary PCI. Fibrinogen can also be used as an additional prognostic inflammatory biomarker for in-hospital mortality in the non-diabetics with STEMI.
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        Value: 10.2298/VSP170905175M
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      – Text: Serbian
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