Improving NSTEMI Outcomes in T2D With NOCS: Efficacy of Incretin

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All-cause death, cardiac death, readmission for ACS, and heart failure were higher in people with diabetes.
All-cause death, cardiac death, readmission for ACS, and heart failure were higher in people with diabetes.

HealthDay News — Incretin treatment appears to improve non-ST-elevation myocardial infarction (NSTEMI) outcomes in patients with type 2 diabetes and non-obstructive coronary artery stenosis (NOCS), according to a study published online in Diabetes, Obesity and Metabolism.

Raffaele Marfella, MD, PhD, from Università degli Studi della Campania in Italy, and colleagues compared the 12-month prognosis of individuals with NOCS-diabetes (20% to 49% luminal stenosis) with first NSTEMI with that of individuals without diabetes. They also investigated the prognosis of NSTEMI-NOCS diabetes patients previously treated with incretin-based therapy with a matched cohort of NSTEMI-NOCS patients never treated with incretin. Patients with diabetes were characterized as current incretin users (6 months, GLP-1 agonists or DPP-4 inhibitors) and never incretin users.

The researchers found that all-cause death, cardiac death, readmission for acute coronary syndrome, and heart failure were higher in patients with diabetes than those without diabetes. Among the diabetes patients, current incretin users had a significantly lower rate of all-cause death, cardiac death, and readmission for ACS through the 12-month period.

"In people with type 2 diabetes with NOCS-NSTEMI, we observed higher incidence of 1-year mortality, and adverse cardiovascular outcomes, as compared to non-diabetic NOCS-NSTEMI patients. In diabetic patients, never-incretin-users have worse prognosis as compared to current-incretin-users," conclude the authors.

Reference

Marfella R, Sardu C, Calabro P, et al. Non-ST-elevation myocardial infarction outcomes in patients with type 2 diabetes with non-obstructive coronary artery stenosis: Effects of incretin treatment [published online September 26, 2017]. Diabetes Obes Metab. doi:10.1111/dom.13122

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