Diabetes May Lead to Worse Prognosis for Patients With Acute Coronary Syndrome
Diabetes in an ACS setting confers a worse prognosis with 1-year mortality.
(HealthDay News) – For patients with acute coronary syndromes (ACS), diabetes confers a worse prognosis, according to a study published in The American Journal of Cardiology.
Raffaele Piccolo, MD, from the Bern University Hospital in Switzerland, and colleagues examined data on the timing of adverse events using pooled patient-level data from 6 studies with 16 601 patients; data were included for 9492 patients with ACS, of whom 20.3% had diabetes mellitus. The authors examined early (0 to 30 days), late (31 to 365 days), and overall adverse events.
The researchers found that all-cause mortality was highest for patients with diabetes with ST-segment elevation myocardial infarction (STEMI; 13.4%) at 1 year, followed by patients with diabetes with non-ST-segment elevation ACS (NSTE-ACS; 10.3%), and was lower for patients without diabetes with STEMI and with NSTE-ACS (6.4% and 4.4%, respectively). There was a significant interaction for STEMI vs NSTE-ACS in early vs late mortality among patients with diabetes, with an excess of early mortality associated with STEMI (9.3% vs 3.7%; hazard ratio: 2.31). Patients with diabetes with STEMI had an increased risk of early stent thrombosis (hazard ratio: 2.26) and a significant interaction in the risk of target lesion revascularization between early and late follow-up, compared to patients with diabetes with NSTE-ACS.
"Diabetes in ACS setting confers a worse prognosis with 1-year mortality >10% in both STEMI and NSTE-ACS," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.