PCI vs. Fibrinolysis in Patients with ST-Elevation MI and Diabetes

In a meta-analysis, the relative benefit of percutaneous coronary intervention in patients with diabetes was similar to that in patients without diabetes.

Randomized trials have demonstrated the relative superiority of primary percutaneous coronary intervention (PCI) to fibrinolysis for reperfusion in patients with ST-segment-elevation MI (STEMI). In patients with diabetes, associated pathophysiological factors, including altered platelet function and greater severity of underlying coronary artery disease, might result in important differences in the relative effectiveness of these two strategies. To investigate this possibility, researchers compared 30-day mortality rates for patients with and without diabetes in a meta-analysis of 19 randomized trials comparing fibrinolysis with primary PCI for patients with STEMI. The trials were conducted between 1990 and 2002.

Patients with diabetes were …

Reviewing Author

Frederick A. Masoudi, MD MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)