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Diabetic patients with acute coronary syndromes in contemporary European registries: characteristics and outcomes

Maddalena Lettino, Pontus Andell, Uwe Zeymer, Petr Widimsky, Nicolas Danchin, Alfredo Bardaji, Jose A. Barrabes, Angel Cequier, Marc J. Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M. Koul, Gilles Lemesle, Thomas F. Lüscher, Christian M. Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez Sendón, Petr Tousek, Franz Weidinger, Clive Weston Orcid Logo, Azfar Zaman, Jin Li, J. Wouter Jukema

European Heart Journal - Cardiovascular Pharmacotherapy

Swansea University Author: Clive Weston Orcid Logo

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DOI (Published version): 10.1093/ehjcvp/pvw049

Abstract

In acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at high risk of recurrent cardiovascular events and premature death. We described patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in 10...

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Published in: European Heart Journal - Cardiovascular Pharmacotherapy
ISSN: 2055-6837 2055-6845
Published: 2017
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URI: https://cronfa.swan.ac.uk/Record/cronfa32499
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Abstract: In acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at high risk of recurrent cardiovascular events and premature death. We described patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in 10 contemporary European registries. In the 10 registries there were 28,899 with and 97,505 without without DM. In the DM population, the proportion of patients with ST-Segment Elevation Myocardial Infarction (STEMI) ranged from 22.1% to 100.0% (other patients had non-ST-Segment Elevation Myocardial Infarction (NSTEMI-ACS) or unstable angina). All-cause mortality in the registries ranged from 1.4% to 9.4% in-hospital; 2.8% to 7.9% at 30 days post-discharge; 5.1% to 10.7% at 180 days post-discharge; and 3.3% to 10.5% at 1 year post-discharge. Major bleeding events were reported in up to 3.8% of patients while in hospital (8 registries); up to 1.3% at 30 days (data from two registries only), and 2.0% at 1 year (one registry only). Registries differed substantially in terms of study setting, site, patient selection, definition and schedule of endpoints, and use of various P2Y12 inhibitors. Pooled risk ratios comparing cohorts with DM vs. no DM were in-hospital significantly higher in DM for all-cause death (1.66; 95% CI 1.42-1.94), for cardiovascular death (2.33; 1.78 - 3.03), and for major bleeding (1.35; 1.21-1.52).
Keywords: acute coronary syndrome, diabetes mellitus, Myocardial infarction, outcomes, registries,
College: Faculty of Medicine, Health and Life Sciences