Diabetes Mellitus and Mortality after Acute Coronary Syndrome as a First or Recurrent Cardiovascular Event
2008

Diabetes and Mortality after Acute Coronary Syndrome

Sample size: 2499 publication Evidence: moderate

Author Information

Author(s): Cubbon Richard M., Abbas Afroze, Wheatcroft Stephen B., Kilcullen Niamh, Das Raj, Morrell Christine, Barth Julian H., Kearney Mark T., Hall Alistair S.

Primary Institution: The University of Leeds

Hypothesis

Is diabetes mellitus associated with poor outcomes in patients presenting with acute coronary syndrome based on their history of cardiovascular disease?

Conclusion

Diabetes mellitus is only associated with worse outcomes after acute coronary syndrome in patients with a pre-existing history of cardiovascular disease.

Supporting Evidence

  • Diabetes was associated with a 45% increase in mortality in the entire cohort.
  • In patients without prior cardiovascular disease, mortality rates were similar regardless of diabetes status.
  • In patients with prior cardiovascular disease, those with diabetes had significantly higher mortality rates.

Takeaway

If you have diabetes and heart problems, you might be at a higher risk of dying after a heart event, but if you don't have heart problems, diabetes doesn't seem to make much difference.

Methodology

Retrospective analysis of a prospective cohort study involving 2499 patients with confirmed acute coronary syndrome across 11 UK hospitals.

Potential Biases

Potential biases due to the observational nature of the study and missing data regarding diabetes or cardiovascular disease status.

Limitations

The study lacked measurements of other cardiovascular risk factors and had counterintuitive rates of secondary preventative therapy.

Participant Demographics

Patients were consecutively admitted with confirmed acute coronary syndrome, with 17.2% having diabetes and 58% having established cardiovascular disease.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0003483

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