Key result
Type 2 diabetes in patients with acute coronary syndrome was associated with a higher risk of subsequent cardiovascular events compared to those without diabetes (26.2% vs 19.0%, P<0.001).
Why the study?
Does type 2 diabetes mellitus increase the risk of subsequent cardiovascular events in patients with acute coronary syndrome?
Cohort (n=140,903)
Does type 2 diabetes mellitus increase the risk of subsequent cardiovascular events in patients with acute coronary syndrome?
Absolute Event Rate: 26.2% vs 19%
p-value: p=<0.001
In patients with acute coronary syndrome, the presence of type 2 diabetes mellitus significantly increases the risk of subsequent cardiovascular events at 1 and 3 years despite higher treatment persistence for certain medications.
Highlights elevated CV risk in ACS with T2DM despite treatment persistence; leaves open whether intensified strategies improve outcomes.
BACKGROUND: The presence of type 2 diabetes mellitus magnifies the risks associated with acute coronary syndrome (ACS), increasing the risk of recurrent cardiovascular events (CVEs) and doubling the risk of death. Managing cardiovascular risk factors has little effect on lowering the mortality risk in patients with type 2 diabetes. OBJECTIVE: To evaluate the relationship between type 2 diabetes mellitus and subsequent CVEs and medication adherence following ACS hospitalization. METHODS: Patients with ACS were identified using ICD-9-CM codes for acute myocardial infarction or unstable angina. The risk of subsequent CVEs was assessed at 1 and 3 years after the index ACS event based on type 2 diabetes status, adjusting for baseline demographic characteristics, comorbidities, medication use, and index ACS characteristics. RESULTS: Of 140,903 patients with ACS (mean age 66.8 years, 58.6% male), 27.4% had type 2 diabetes. During follow-up, 22.0% had subsequent CVEs (26.2% type 2 diabetes, 19.0% nondiabetes). After adjusting for other covariates, type 2 diabetes was associated with increased risk of subsequent CVEs by 9.7% at 1 year and 10.2% at 3 years (both P < 0.001). Most patients were not revascularized at first recurrence after index ACS discharge (79.2% type 2 diabetes, 77.5% nondiabetes). Patients with type 2 diabetes had statistically significant higher adherence rates for antiplatelet agents at 1 year and antihypertensives at 1 and 3 years versus nondiabetes patients. Persistence was higher in the type 2 diabetes group for antihypertensives and in the nondiabetes group for antiplatelet agents and statins. CONCLUSIONS: This analysis demonstrates that patients with type 2 diabetes have a higher risk of subsequent CVEs following an initial event versus those without diabetes, despite evidence of higher treatment persistence for certain medications. Adherence rates remained suboptimal, suggesting a continuing need for patient education.
No takes yet. Share an insight, caveat, or question.
Cziraky et al. (2015) conducted a cohort in Acute Coronary Syndrome (n=140,903). Type 2 diabetes mellitus vs. Without type 2 diabetes mellitus was evaluated on Subsequent cardiovascular events (CVEs) (p=<0.001). Type 2 diabetes in patients with acute coronary syndrome was associated with a higher risk of subsequent cardiovascular events compared to those without diabetes (26.2% vs 19.0%, P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: