Diabetes Prognosis Worse for Acute Coronary Syndrome Patients
HealthDay News — For patients with acute coronary syndromes (ACS), diabetes confers a worse prognosis, according to a study published in the August 1 issue of 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 six studies with 16,601 patients; data were included for 9,492 patients with ACS, of whom 20.3% had diabetes mellitus. The authors examined early (zero 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; 13.1%) at one 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 versus NSTE-ACS in early versus late mortality among patients with diabetes, with an excess of early mortality associated with STEMI (9.3 versus 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 one-year mortality >10% in both STEMI and NSTE-ACS," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.