Savic, Lidija (16507811000)Lidija (16507811000)SavicMrdovic, Igor (10140828000)Igor (10140828000)MrdovicAsanin, Milika (8603366900)Milika (8603366900)AsaninStankovic, Sanja (7005216636)Sanja (7005216636)StankovicLasica, Ratko (14631892300)Ratko (14631892300)LasicaKrljanac, Gordana (8947929900)Gordana (8947929900)KrljanacSimic, Damjan (58010380500)Damjan (58010380500)Simic2025-06-122025-06-122025https://doi.org/10.1016/j.cjco.2024.10.001https://www.scopus.com/inward/record.uri?eid=2-s2.0-85211073085&doi=10.1016%2fj.cjco.2024.10.001&partnerID=40&md5=a22d86230887359a175c5d1bce13a1afhttps://remedy.med.bg.ac.rs/handle/123456789/663Background: Insulin- and non–insulin treated diabetes (ITDM and NITDM) have different prognostic impact in patients with myocardial infarction and/or heart failure. The aim of this study was to analyze the prognostic impact of ITDM and NTIDM on the incidence of all-cause mortality and major adverse cardiovascular events (MACE— cardiovascular death, nonfatal infarction, nonfatal stroke, and target vessel revascularization) in the 8-year follow-up of patients with ST-segment elevation myocardial infarction (STEMI) with a reduced ejection fraction (EF). Methods: We analyzed 2230 consecutive STEMI patients treated with primary percutaneous coronary intervention and with EF < 50%. Echocardiographic examination was performed after primary percutaneous coronary intervention. Patients were divided into 3three groups: those with ITDM, those with NITDM, and those with no DM. Patients presenting with cardiogenic shock were excluded. Results: The incidence of DM was 20.7%; among the patients with DM, 103 (22.3%) had ITDM. Patients with ITDM and NITDM had a higher incidence of mortality and MACE, compared with patients without DM. Also, at 8-year follow-up, the incidences of all-cause mortality and MACE were significantly higher in patients with ITDM vs patients with NITDM (37.8% vs 13.1%, P < 0.001 and 40.8% vs 18.9%, P < 0.001, respectively). Multivariable analysis showed ITDM to be an independent predictor for long-term mortality (hazard ratio 1.76, 95% confidence interval 1.15-2.69), and MACE (hazard ratio 1.72, 95% confidence interval 1.15-2.62). Conclusions: ITDM was an independent predictor of the occurrence of long-term mortality and MACE in patients with STEMI and reduced EF. NITDM was not an independent predictor for the occurrence of adverse events in analyzed patients. © 2024 The Authors