Clinical characteristics,treatments and outcome of diabetic patients with non-ST elevation acute coronary syndromes in China
10.3760/cma.j.issn.0253-3758.2011.05.003
- VernacularTitle:糖尿病合并非ST段抬高急性冠状动脉综合征患者的临床特点、治疗及远期预后
- Author:
Li-Tian YU
1
;
Hui-Qiong TAN
;
Jun ZHU
;
Yan ZHANG
;
Jian-Dong LI
;
Li-Sheng LIU
;
On behalf of Chinese Coordinating Center of Organization to Assess Strategies for Ischemic Syndromes Registry
Author Information
1. 中国医学科学院北京协和医学院,心血管病研究所阜外心血管病医院
- Keywords:
Coronary disease;
Diabetes mellitus;
Prognosis
- From:
Chinese Journal of Cardiology
2011;39(5):390-396
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical characteristics,treatment options and outcome of diabetic patients with non-ST elevation acute coronary syndromes(NSTEACS).Methods Consecutive patients admitted with NSTEACS from 38 centers in north China were enrolled.Medical histories,clinical characteristics,treatments and outcomes were evaluated and follow-up was made at 6,12,and 24 months 'after their initial hospital admission.Cumulative event rates were compared between diabetic and nondiabetic patients.Results There were 420 diabetic patients out of 2294 NSTEACS patients(18.3%).Diabetic patients were older[(64.9±6.7)years vs.(62.3±8.6)years,P<0.01],more often women (48.1% vs.35.3%,P<0.05)and were associated with higher baseline comorbidities such as previous hypertension,myocardial infarction,congestive heart failure and stroke than non-diabetic patients.The incidence of antiplatelet therapy(92.1% vs.95.O%,P<0.05),coronary angiography(30.0% vs.36.3%,P<0.05)and revascularization(12.1% vs.18.8%,P<0.05)was lower in patients with diabetes than non-diabetic patients.In hospital and 2-year mortality as well as the incidence of congestive heart failure and composite outcomes of myocardial infarction,stroke,congestive heart failure and death were substantially higher in diabetic patients compared with non-diabetic patients.Muhivariative Cox regression analysis revealed that age≥70 years,diabetes,previous myocardial infarction,previous congestive heart failure,systolic blood pressure less than 90 mm Hg(1 mm Hg=0.133 kPa)and heart rate more than 100bpm at admission were risk factors for 2-year death.Conclusion In NSTEACS,diabetes is associated with higher rate of in-hospital and 2-year death,congestive heart failure and composite outcomes of myocardial infarction,stroke,congestive heart failure and death.Diabetes mellitus is a major independent predictor of 2-year mortaliy post NSTEACS.Status of antiplatelet therapy,coronary angiography and revascularization should be improved for diabetic patients with NSTEACS during hospitalization.
