Diabetics With Acute Coronary Syndrome at High Risk

Almost one in eight diabetics hospitalized for acute coronary syndrome (ACS) do not survive for 6 months, according to the results of a new study. Dr. M. D. Flather of the Royal Brompton Hospital and Harefield NHS Trust, London and colleagues note that there is evidence that diabetics with ACS are at increased risk of subsequent adverse effects.

To investigate further, the researchers examined data on an unselected UK population of 1046 ACS patients with or without diabetes mellitus who were admitted with non-ST elevation MI or unstable angina.

One hundred seventy (16%) had a prior diagnosis of diabetes, according to the report in the April issue of the International Journal of Cardiology. The diabetics had a significantly higher level of morbidities at baseline as well as a higher unadjusted mortality rate at 6 months (11.8%) than those without the condition (6.4%).

After adjustment for a variety of factors including age, gender, hypertension and coronary revascularization, mortality rates were no longer significantly elevated in the diabetics. The hazard ratio was 1.35 at 6 months and 1.15 at 4 years.

Nevertheless, the researchers point out that over 4 years of follow-up, 30% of the diabetic patients died.

In light of these findings, the team concludes that "diabetes mellitus patients should be managed aggressively to reduce their risk of future complications."

Int J Cardiol 2005;100:79-84.

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