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Statin therapy improves glycemic control in diabetic patients admitted with acute coronary syndromes.

Session Poster session 4

Speaker Aline Gehlen Ferrari

Congress : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes - Treatment
  • Session type : Poster Session
  • FP Number : P3686

Authors : RHM Furtado (Sao Paulo,BR), TF Dalcoquio (Sao Paulo,BR), LM Baracioli (Sao Paulo,BR), FG Lima (Sao Paulo,BR), A Franci (Sao Paulo,BR), FR Menezes (Sao Paulo,BR), PRR Genestreti (Sao Paulo,BR), AG Ferrari (Sao Paulo,BR), VM Lima (Sao Paulo,BR), R Kalil Filho (Sao Paulo,BR), JC Nicolau (Sao Paulo,BR)

Authors:
R.H.M. Furtado1 , T.F. Dalcoquio1 , L.M. Baracioli1 , F.G. Lima1 , A. Franci1 , F.R. Menezes1 , P.R.R. Genestreti1 , A.G. Ferrari1 , V.M. Lima1 , R. Kalil Filho1 , J.C. Nicolau1 , 1Heart Institute (InCor) - University of Sao Paulo Faculty of Medicine (FMUSP) - Sao Paulo - Brazil ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 799

Introduction: Statins are a well-established therapy for patients with coronary artery disease. However, recent reports in medical literature have linked statin therapy to increased incidence of diabetes mellitus. Although the definitive explanation for this finding is still unclear, there is some evidence that statins could impair beta-cell function and reduce insulin secretion. On the other hand, there is also some evidence that statins could decrease insulin resistance. Further, it is plausible that so-called pleiotropic anti-inflammatory actions of statins could even improve glycemia. Concerning patients with acute coronary syndromes (ACS), little is known about a possible role of statins over glycemic parameters.

Purpose: We conducted a databank retrospective analysis to investigate if statin therapy could modify glycemic control during hospital stay in diabetic patients admitted with ACS.

Methods: We collected data concerning consecutive patients admitted to a Coronary Care Unit (CCU) with a diagnosis of ACS. Only individuals with previous diagnosis of diabetes mellitus were included in this analysis. We sought to compare admission (first) and peak whole blood glucose between those individuals on statin therapy before admission (statin group) versus those ones who were not taking statins (statin naive group). After admission, all patients were prescribed statins on a routine basis in accordance to current guidelines and CCU standard of care.

Results: A total of 663 individuals were included. Results are depicted at table 1

Conclusions: Diabetic individuals on previous statin therapy admitted with ACS had better glycemic control than those ones without previous statin treatment. This raises the hypothesis that statins could improve glycemia in the acute phase of ACS, despite the current concerns about increased incidence of diabetes mellitus with statin therapy.

Table 1
Statin group (n=401)Statin naive group (n=262)p (univariate analysis)p (adjusted analysis)
1st blood glucose in mg/dL (mean ± SD)171.7±84.9193.6±97.50.0020.129
Peak blood glucose in mg/dL (mean ± SD)179.2±86.4203.3±100.40.0010.042
Rate of hyperglycemia136.4%48.1%0.0030.009
Rate of hyperglycemia218.2%27.8%0.0030.014
HbA1c (mean ± SD)7.8±5.78.1±2.10.4030.270
Admission C-reactive protein in mg/L (mean ± SD)67.7±95.8111.3±114.1<0.00010.026
1Defined as peak blood glucose > median (I.E. >185 mg/dL). 2Defined as peak blood glucose >250 mg/dL (the cutoff at which i.v. continous insulin therapy is started per CCU routine).

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