Department of Internal medicine, United Arab Emirates University- College of Medicine and Health Sciences, Al Ain, United Arab Emirates.
Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
Curr Vasc Pharmacol. 2020;18(1):68-76. doi: 10.2174/1570161116666181024094337.
The prevalence of traditional risk factors such as diabetes mellitus (DM) and obesity are increasing in patients with acute coronary syndrome (ACS). Furthermore, outcomes after ACS are worse in patients with DM. The high prevalence of DM and an early age at onset of ACS have been described in prior publications from the Gulf Coast Database.
We aimed to define the effect of DM on total mortality following ACS presentation at 30-days and 1 year based on the Gulf COAST registry database.
The Gulf COAST registry is a prospective, multinational, longitudinal, observational cohort study conducted among Gulf citizens admitted with a diagnosis of ACS. The outcomes among patients with DM following ACS were stratified into 2 groups based on their DM status. Cumulative survival stratified by groups and subgroup categories was assessed by the Kaplan-Meier method.
Of 3,576 ACS patients, 2,730 (76.3%) presented with non ST-segment elevation myocardial infarction (NSTEMI) and 846 (23.6%) with STEMI. Overall, 1906 patients (53.3%) had DM. A significantly higher in-hospital (4.8%), 30-day (6.7%) and 1-year (13.7%) mortality were observed in patients with DM compared with those without DM. The Kaplan-Meier survival curve showed significant differences in survival of ACS patients with or without DM, with a short period of time-to-event for DM patients with STEMI (30-days) and the longest (1-year) for NSTEMI patients without DM.
DM patients presenting with ACS-STEMI have poor short-term outcomes while DMNSTEMI patients have poor long-term outcomes. This highlights the need for strategies to evaluate DM control and integration of care to control vascular risk among this high-risk population.
在急性冠状动脉综合征（ACS）患者中，糖尿病（DM）和肥胖等传统危险因素的患病率正在增加。此外，患有 DM 的 ACS 患者的预后更差。海湾海岸数据库中的先前出版物已经描述了 DM 的高患病率和 ACS 发病年龄较早。
我们旨在根据海湾海岸登记数据库定义 DM 对 ACS 发病后 30 天和 1 年总死亡率的影响。
海湾海岸登记处是一项前瞻性、多国、纵向、观察性队列研究，在海湾公民中进行，这些公民因 ACS 诊断而入院。根据 DM 状态，将 ACS 后 DM 患者的结果分为两组。通过 Kaplan-Meier 方法评估按组和亚组分类分层的累积生存率。
在 3576 例 ACS 患者中，2730 例（76.3%）表现为非 ST 段抬高型心肌梗死（NSTEMI），846 例（23.6%）表现为 ST 段抬高型心肌梗死。总体而言，1906 例患者（53.3%）患有 DM。与无 DM 的患者相比，DM 患者的院内（4.8%）、30 天（6.7%）和 1 年（13.7%）死亡率明显更高。Kaplan-Meier 生存曲线显示 ACS 患者有或无 DM 的生存存在显著差异，DM 患者 STEMI 的时间事件较短（30 天），而无 DM 的 NSTEMI 患者的时间事件最长（1 年）。
患有 ACS-STEMI 的 DM 患者短期预后不良，而患有 DMNSTEMI 的患者长期预后不良。这凸显了需要制定策略来评估 DM 控制并整合护理，以控制这一高危人群的血管风险。
