Key result
Undiagnosed diabetes detected during ACS is linked to ~93% higher risk of in-hospital MACE.
Why the study?
There is a strong relationship between diabetes mellitus and cardiovascular mortality and morbidity, but the rates and predictors of incidentally detected diabetes and pre-diabetes at ACS diagnosis were unclear.
What are the predictors of incidentally detected diabetes and pre-diabetes in patients presenting with acute coronary syndrome, and how do they affect the risk of major adverse cardiovascular events?
Cross-Sectional (n=1,882)
No
What are the predictors of incidentally detected diabetes and pre-diabetes in patients presenting with acute coronary syndrome, and how do they affect the risk of major adverse cardiovascular events?
Odds Ratio: 1.927 (95% CI 1.475–2.517)
Absolute Event Rate: 35.82% vs 22.16%
p-value: p=<0.001
Undiagnosed diabetes and pre-diabetes are frequently detected at the time of acute coronary syndrome presentation and are independently associated with an increased risk of major adverse cardiovascular events.
Objective: There is a strong relationship between diabetes mellitus (DM) and cardiovascular diseases-related mortality and morbidity. Patients with DM are more likely to have more serious cardiovascular diseases and have higher complication rates than nondiabetic individuals. We aimed to investigate the rates of DM and preDM that were detected incidentally at the time of index acute coronary syndrome (ACS) and the factors that could predict incidental DM and pre-DM. Also, to investigate the factors associated with major adverse cardiovascular events (MACE) due to ACS. Material and Methods: This retrospective study included 1,882 patients without known DM or pre-DM diagnoses who were hospitalized and treated for ACS. The patients were divided into the following three classes: non-DM (n=582), pre-DM (n=602), and undiagnosed DM (un-DM, n=698). Results: We found that higher age (p<0.001), female sex (p<0.001), higher body mass index (p<0.001), hyperlipidemia (p<0.001), previous peripheral artery disease (p=0.012), previous cerebrovascular disease (p=0.021), and renal diseases (p=0.017) were independently associated with pre-DM and un-DM. High age (p<0.001), renal diseases (p<0.001), ST-elevation myocardial infarction (p=0.008), un-DM (p<0.001), and pre-DM (p=0.044) were independently associated with an increased MACE risk, while hyperlipidemia (p<0.001) and antiaggregant use (p=0.012) were independently associated with a decreased MACE risk. Conclusion: The above-mentioned risk factors can be used to predict (pre)DM before ACS or to assess MACE risk after ACS. Such risk stratification may contribute to reducing cardiovascular mortality and morbidity that are increased by (pre)DM and MACE.
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Özbek et al. (2023) conducted a cross-sectional in Acute Coronary Syndrome (n=1,882). Undiagnosed diabetes (un-DM) vs. Non-diabetes (Non-DM) was evaluated on Major adverse cardiovascular events (MACE) (OR 1.927, 95% CI 1.475-2.517, p=<0.001). Undiagnosed diabetes incidentally detected during acute coronary syndrome was independently associated with an increased risk of in-hospital major adverse cardiovascular events (OR 1.927) compared to patients without diabetes.
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