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Diabetes: the most important predictor of new cardiovascular events after acute coronary syndrome?

Session Poster Session III - Friday 08:30 - 12:30

Speaker Raquel Ferreira

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Diabetes and the Heart
  • Session type : Poster Session

Authors : R Ferreira (Aveiro,PT), J Neves (Aveiro,PT), A Gonzaga (Aveiro,PT), M Bastos (Aveiro,PT), J Santos (Aveiro,PT)

Authors:
R Ferreira1 , J Neves1 , A Gonzaga1 , M Bastos1 , J Santos1 , 1Centro Hospitalar do Baixo Vouga, Cardiology - Aveiro - Portugal ,

Citation:

Purpose: Coronary heart disease is a chronic condition and patients who have recovered from an acute coronary syndrome are at high risk for new events and premature death.

Methods: Retrospective observational analysis of 431 patients admitted on a coronary intensive care unit with acute coronary syndrome for 2 consecutive years. Patients were followed-up until the 31st october 2013 or until another event (new acute coronary syndrome, stroke, heart failure, arrhythmia or cardiac death).
Results: 431 patients were included, 72.4% were male, with mean age of 67 ± 13 years, 27.6% with the previous diagnosis of Diabetes. During the mean follow-up of 22 ± 10 months, 73 cardiovascular events were recorded and 48 deaths, 15 of which were of cardiac cause. On Cox multivariate analysis adjusted to potential confounding factors (diabetes, hypertension, dyslipidemia, obesity and tabagism) only diabetes (with Hazzard Ratio of 0.61; IC 95% 0.368-1.011; p< 0.05) was sustained as an independent predictor of new cardiovascular events. Comparing diabetic versus non diabetic patients, diabetic had higher values of glycaemia on admission, serum creatinine, pro-B-type natriuretic peptide and C-reactive protein. They also had higher values ??of systolic blood pressure and heart rate on admission. Atrial fibrillation and electrocardiographic dynamic changes in the inferior wall were also more frequent in this group. Killip class IV (2.5% vs 1.6%), severe depression of left ventricle ejection fraction (11% vs 10%)  and 3-vessel disease (32.6% vs 12.8%) were more prevalent in the diabetes group. Non-diabetic patients were younger and had higher values of hemoglobin, troponin I and total cholesterol.

Conclusion: Diabetes was the only cardiovascular risk factor that was sustained as a predictor of new cardiovascular events. Thus, patients with acute coronary syndrome present an opportunity for targeted screening for diabetes and institution of effective management strategies aimed to improve cardiovascular outcome.

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