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[Ischemic heart disease mortality risk in patients with diabetes mellitus]

Remigijus Zaliūnas1, Marija Rūta Babarskiene, Dalia Luksiene

  • 1Clinic of Cardiology, Kaunas University of Medicine, Sukileliu 17, 3007 Kaunas, Lithuania.

Medicina (Kaunas, Lithuania)
|July 25, 2003
PubMed

Insights

Diabetes mellitus significantly increases the risk of death by twofold within one year following acute coronary syndrome. This highlights the need for tailored risk stratification in diabetic patients after a heart attack.

Area of Science:

  • Cardiology
  • Diabetology
  • Public Health

Background:

  • Clinical factors during acute coronary syndrome (ACS) predict hospital prognosis.
  • Prognostic value of these factors for one-year lethal outcomes in diabetic patients post-ACS is unclear.

Purpose of the Study:

  • To evaluate the prognostic significance of clinical characteristics in patients with diabetes mellitus (DM) following their first acute coronary syndrome (ACS).
  • To assess the impact of DM on the risk of lethal outcomes one year after ACS.

Main Methods:

  • Prospective one-year follow-up of 699 patients with first ACS (61 with DM, 638 without).
  • Analysis of demographic, risk factor, clinical, echocardiographic, and angiographic data.
  • Assessment of cardiac death during the follow-up period.

Main Results:

  • Diabetic patients were more likely to be older, female, hypertensive, obese, and have tachycardia, severe left ventricular failure, and three-vessel coronary disease.
  • Diabetes mellitus independently increased the odds ratio (OR) of lethal outcomes by 1.5-2.5 fold.
  • A general risk score of ≥14 identified high-risk patients; 48.3% of diabetic patients fell into this category, with a 36.5% mortality rate.

Conclusions:

  • Diabetes mellitus doubles the risk of lethal outcomes within one year after acute coronary syndrome.
  • Clinical characteristics predict outcomes, but DM presence further stratifies risk, necessitating specific management strategies.
Abstract

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