[Acute coronary syndromes in hospitalized patients with diabetes. Data from the RECORD registry]

Diabetes is an acknowledged risk factor of unfavorable outcome in patients with acute coronary syndromes (ACS). According to modern guidelines patients with ACS and diabetes should be treated more aggressively than patients of lower risk. However systematic data on treatment of ACS patients with diabetes in real life hospitals in Russia are lacking. AIM; To analyze main clinical characteristics, inhospital treatment, and outcomes of patients with diabetes included in Russian independent ACS register RECORD.

RECORD embraced 18 hospitals of various types from 13 cities. Number of included patients both with ST elevation and non-ST elevation ACS (STEACS and NSTEACS) was 796; 124 patients (15.6%) reported diagnosis of diabetes mellitus at admission.

Patients with diabetes compared with those without were significantly older and more often had other cardiovascular risk factors, signs of heart failure and high GRACE score at admission. Nevertheless their treatment in RECORD was characterized by relatively low rate of invasive interventions and use of certain medications (clopidogrel, statins) and was similar to treatment of patients without diabetes. Hospital mortality of patients with diabetes compared with mortality of those without was substantially and significantly higher (16.9 and 5.2%, respectively, <0.0001). Inhospital outcomes in patients with diabetes depended on activity of treatment and were better in patients subjected to primary PCI (STEACS) and receiving clopidogrel (NSTEACS). But small dimensions of respective subgroups precluded distinguishing between true effect of these treatments or selection for them of patients with relatively lower risk.