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( Doo Sun Sim ),( Myung Ho Jeong ),( Young Keun Ahn ),( Young Jo Kim ),( Shung Chull Chae ),( Taek Jong Hong ),( In Whan Seong ),( Jei Keon Chae ),( Chong Jin Kim ),( Myeong Chan Cho ),( Seung Woon Rh 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Prognostic implications of BBB in diabetic patients with acute MI have yet to be clarifi ed. Methods: We analyzed 23,724 patients with acute MI from the Korea Acute Myocardial Infarction Registry and the Korea Working Group on Myocardial Infarction Registry. Twelve-month clinical outcome was compared between patients with BBB and those without BBB according to the presence of DM. Results: Patients with left BBB (n = 181) were older, more likely to be men, have hypertension, DM, multi-vessel disease, left ventricular dysfunction, less likely to have chest pain at presentation and receive percutaneous coronary intervention (PCI) and beta blockers. Allcause mortality and the rate of major adverse cardiac events (MACE: all-cause mortality, MI, and repeat revascularization) were higher in patients with left BBB at 1 month and 12 months. Patients with right BBB (n = 494) were older, more likely to be men, have prior stroke, less likely to have chest pain at presentation and PCI. All-cause mortality and MACE were similar at 1 month, but higher in patients with right BBB at 12 months. Diabetics with left BBB, compared to diabetics without left BBB, had higher prevalence of multi-vessel disease (80% vs. 65%, p = 0.024), which was similar in non-diabetics regardless of the presence of left BBB. On multivariate analysis, left BBB was associated with 12-month allcause mortality in diabetics (hazard ratio: 2.6; 95% confi dence interval: 1.25 to 5.25; p = 0.010), but not in non-diabetics, while right BBB was not an independent predictor of death regardless of diabetic status. Conclusions: In patients with acute MI, BBB was associated with worse 12-month clinical outcome. Particularly in diabetics, left BBB was associated with more extensive coronary artery disease and higher mortality.