Key result
Increasing age is linked to ~6% lower risk of poor glycemic control in post-ACS DM patients.
Why the study?
DM predicts recurrent ischaemic events in ACS and cardiovascular disease leads mortality in diabetes, but the prevalence, glycemic control, and predictors of poor control in this population required evaluation.
Cross-Sectional (n=486)
No
Odds Ratio: 0.94 (95% CI 0.9–0.97)
p-value: p=<0.001
In patients with acute coronary syndrome, diabetes is highly prevalent (42.6%) and often poorly controlled, though increasing age is associated with better glycemic control.
High DM prevalence with frequent poor control in ACS supports routine screening; leaves open age-targeted interventions before practice change.
Introduction: Diabetes mellitus (DM) is a predictor of recurrent ischaemic events in patients with the acute coronary syndrome (ACS) whilst cardiovascular disease remains the leading cause of mortality among patients with diabetes. This study aims to determine the prevalence of DM, glycemic control and predictors of poor glycemic control patients diagnosed with ACS in our population. Methods: This is a single centre, cross-sectional study of ACS patients admitted to cardiology wards, Hospital Serdang. A chi-square test was used to test the association between the prescribing pattern of antihyperglycemic agents and the glycemic control of DM patients. Logistic regression analysis was performed to determine the predictors of poorly glycemic controlled among DM patients with ACS. Results: A total of 486 patients were included (male 73.4%; mean age 57.3(12.5) years). The prevalence of DM among ACS patients was 207 (42.6%). Of these, 88 (42.1%) had poorly-controlled DM with the HbA1c > 8% and 81 (47.9%) had well control the HbA1c≤8%. Significant association was found between antihyperglycemic agents, i.e. insulin (p<0.034), metformin (p<0.038) and sulphonylurea (p<0.022). In poor control group, insulin is the most prescribed antihyperglycemic agents, 35 (37.2%) compared to well control, metformin is the highest proportion, 25 (34.7%). In multivariate analysis, only age was independently predictive of poorly controlled among DM patients with ACS (adjusted OR 0.94; 95% CI 0.90-0.97; p<0.001). Conclusion: This study found, the prevalence of DM was high among ACS patient, with half of them demonstrate poor glycemic control. This study found that increasing age was associated with a lower risk of poor glycemic control among DM patients with recent ACS.
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Daud et al. (2022) conducted a cross-sectional in Acute Coronary Syndrome and Diabetes Mellitus (n=486). Increasing age vs. Younger age was evaluated on Poor glycemic control (HbA1c > 8%) (adjusted OR 0.94, 95% CI 0.90-0.97, p=<0.001). Increasing age was independently associated with a lower risk of poor glycemic control among diabetes mellitus patients with recent acute coronary syndrome (adjusted OR 0.94).
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