Presentation, management, and outcomes of diabetic patients compared to non-diabetic patients admitted for acute coronary syndromes

Several prior studies have shown that patients with diabetes mellitus have worse in-hospital outcomes compared to non-diabetic patients when admitted for an acute myocardial infarction (MI).1,2 Few studies have examined this same issue among patients admitted across the entire spectrum of acute coronary syndromes (ACS) (unstable angina, non-ST elevation MI, ST elevation MI).3,4 Since patients admitted with these diagnoses make up a large proportion of admissions to cardiology services and diabetic patients represent a sizeable portion of these patients, investigation of this cohort is clinically pertinent. In the present study, we analysed patients with and without diabetes, with the goal of systematically examining similarities and differences in presentation, management, and outcomes when admitted for ACS. We studied 1951 consecutive patients who were admitted to the University of Michigan Medical Center from 27 December 1998 to 16 October 2002 with a diagnosis of ACS. The protocol was approved by the institutional review board at the University of Michigan and informed consent was obtained from all patients. Diabetes was defined as a known history of type I or type II diabetes mellitus treated with diet, oral glucose lowering agents, or insulin. Patients utilising insulin for the management of their diabetes before admission were included in the insulin treated diabetic …