| ORIGINAL ARTICLE |
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| Year : 2018 | Volume
: 2
| Issue : 1 | Page : 28-34 |
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Modifying effect of diabetes on the short-term effect of clopidogrel in patients with myocardial infarction
Wuxiang Xie1, Lin Feng2, Xian Li3, Runlin Gao4, Yangfeng Wu5
1 Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
2 Peking University Clinical Research Institute, Peking University Health Science Center; Peking University First Hospital, Beijing, China
3 The George Institute for Global Health at Peking University Health Science Center, Beijing, China
4 Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
5 Peking University Clinical Research Institute, Peking University Health Science Center; The George Institute for Global Health at Peking University Health Science Center, Beijing, China
Correspondence Address:
Dr. Yangfeng Wu
Peking University Clinical Research Institute and School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road; The George Institute for Global Health at Peking University Health Science Center, No. 6 Zhichun Road, Haidian District, 100088, Beijing
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/hm.hm_13_18
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Background: Patients with diabetes are reported having inadequate response to clopidogrel treatment compared with patients without diabetes. The present study aims to investigate the effect of clopidogrel treatment in lowering in-hospital major adverse cardiovascular events (MACEs) among hospitalized myocardial infarction (MI) patients with and without diabetes. Materials and Methods: This is a post hoc analysis of the third phase of Clinical Pathways in Acute Coronary Syndromes program study. Between October 2011 and November 2014, a total of 14,997 patients with MI were consecutively recruited from 101 county hospitals without the capacity to perform onsite percutaneous coronary intervention (PCI). Results: The mean age of the 14,997 patients with MI was 64.8 ± 12.2 years, and 67.5% of the participants were male. Of these patients, 1920 (12.8%) were classified as diabetes when presenting at the hospital, and 12,875 (85.9%) patients received in-hospital clopidogrel treatment. In total, 167 patients (8.7%) with and 955 patients (7.3%) without diabetes experienced an in-hospital MACE. Multivariable-adjusted relative risk (RR) associated with clopidogrel treatment for in-hospital MACEs was 0.79 (95% confidence interval [CI]: 0.68–0.93) among all MI patients, and it was also consistent between patients with (RR = 0.79, 95% CI: 0.54–1.16) and without diabetes (RR = 0.79, 95% CI: 0.65–0.95; P for interaction = 0.970). Propensity score-matched subgroup analyses yielded similar results. Conclusion: Our large-scale study of real-world data from non-PCI-capable hospitals in China demonstrated that clopidogrel treatment was associated with a lower risk of in-hospital MACEs in MI patients, and this effect was not modified by diabetes. |
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