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Diabetes Linked to Higher Mortality After Acute Coronary Syndromes

Patients with acute coronary syndromes experience higher mortality if they also have diabetes, according to a JAMA study.

Researchers pooled data on some 62,000 patients with acute coronary syndromes who were participants in 11 independent randomized trials from 1997 to 2006. About 17% of the patients had diabetes.

After controlling for other factors, the researchers found that diabetes was independently linked with higher mortality 30 days after ST-segment elevation myocardial infarction (odds ratio, 1.40) and after unstable angina/non-STEMI (OR, 1.78). After 1 year, the risk for death in patients with diabetes who had UA/NSTEMI approached that of patients without diabetes who had STEMI (7.2% vs. 8.1%).

The authors conclude: "Despite modern therapies for [acute coronary syndromes], diabetes confers a significant adverse prognosis, which highlights the importance of aggressive strategies to manage this high-risk population with unstable ischemic heart disease."

Link: JAMA article (Free abstract; full text requires subscription)

Published in Physician's First Watch August 15, 2007

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