Acute coronary syndrome in patients with type 2 diabetes mellitus: analysis of Russian hospital care
https://doi.org/10.14341/2072-0351-5515
Abstract
Aims.
To analyze basic clinical characteristics, inhospital therapeutic approaches and outcomes in patients with acute coronary syndrome(ACS) and diabetes mellitus (DM).
Materials and methods.
Patients were included in this study according to the protocol, established for Russian ACS Registry (RECORD),based on data from 18 hospitals operating in 13 Russian cities.
Results.
796 patients took part in the current study. 15.6% reported diagnosis of DM at admission. We observed positive correlationbetween initial glycemic levels and presence of DM (r=0.43; р<0,001). Patients with DM were elder and more often had othercardiovascular risk factors, signs of chronic heart failure and increased GRACE score at admission. However, therapeutic approachdid not significantly differ between patients with and without DM, while hospital mortality rate was substantially higher in diabeticpatients as compared to non-diabetic (16.9% and 5.2%, respectively; p<0,0001). We determined a certain dependence of outcomeson the aggressiveness of treatment. In particular, we show that percutaneous coronary intervention and clopidogrel were more effectivein patients with DM, who suffered from ST-elevation ACS (STEACS).
Conclusion.
Patients with ACS and DM comorbidity tend to have worse prognosis, and diagnosis of DM is an independent predictor oflethal inhospital outcomes. Nevertheless, treatment tactics remains similar between patients with DM and without it.
To analyze basic clinical characteristics, inhospital therapeutic approaches and outcomes in patients with acute coronary syndrome(ACS) and diabetes mellitus (DM).
Materials and methods.
Patients were included in this study according to the protocol, established for Russian ACS Registry (RECORD),based on data from 18 hospitals operating in 13 Russian cities.
Results.
796 patients took part in the current study. 15.6% reported diagnosis of DM at admission. We observed positive correlationbetween initial glycemic levels and presence of DM (r=0.43; р<0,001). Patients with DM were elder and more often had othercardiovascular risk factors, signs of chronic heart failure and increased GRACE score at admission. However, therapeutic approachdid not significantly differ between patients with and without DM, while hospital mortality rate was substantially higher in diabeticpatients as compared to non-diabetic (16.9% and 5.2%, respectively; p<0,0001). We determined a certain dependence of outcomeson the aggressiveness of treatment. In particular, we show that percutaneous coronary intervention and clopidogrel were more effectivein patients with DM, who suffered from ST-elevation ACS (STEACS).
Conclusion.
Patients with ACS and DM comorbidity tend to have worse prognosis, and diagnosis of DM is an independent predictor oflethal inhospital outcomes. Nevertheless, treatment tactics remains similar between patients with DM and without it.
About the Authors
Aleksey Dmitrievich Erlikh
Institute of Physical-Chemical Medicine, Moscow
Nikolay Andreevich Gratsianskiy
Institute of Physical-Chemical Medicine, Moscow
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For citations:
Erlikh A.D., Gratsianskiy N.A. Acute coronary syndrome in patients with type 2 diabetes mellitus: analysis of Russian hospital care. Diabetes mellitus. 2012;15(2):27-31. (In Russ.) https://doi.org/10.14341/2072-0351-5515
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