糖尿病与胸痛患者急性冠脉综合征风险：初级保健非工作时间的横断面研究。

Diabetes and risk of acute coronary syndrome in callers with chest discomfort: Cross-sectional study in out-of-hours primary care.

机构信息

Department of General Practice & Nursing Science, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.

出版信息

Diabetes Res Clin Pract. 2024 Jun;212:111684. doi: 10.1016/j.diabres.2024.111684. Epub 2024 Apr 30.

DOI:10.1016/j.diabres.2024.111684

PMID:38697299

Abstract

AIMS

We investigated the differences in prevalence of acute coronary syndrome (ACS) by presence versus absence of diabetes in males and females with chest discomfort who called out-of-hours primary care (OHS-PC).

METHODS

A cross-sectional study performed in the Netherlands. Patients who called the OHS-PC in the Utrecht region, the Netherlands between 2014 and 2017 with acute chest discomfort were included. We compared those with diabetes with those without diabetes. Multivariable logistic regression was used to determine the relation between diabetes and (i) high urgency allocation and (ii) ACS.

RESULTS

Of the 2,195 callers with acute chest discomfort, 180 (8.2%) reported having diabetes. ACS was present in 15.3% of males (22.0% in those with diabetes) and 8.4% of females (18.8% in those with diabetes). Callers with diabetes did not receive a high urgency more frequently (74.4% vs. 67.8% (OR: 1.38; 95% CI 0.98-1.96). However, such callers had a higher odds for ACS (OR: 2.17; 95% CI 1.47-3.19). These differences were similar for females and males.

CONCLUSIONS

Diabetes holds promise as diagnostic factor in callers to OHS-PC with chest discomfort. It might help triage in this setting given the increased risk of ACS in those with diabetes.

摘要

目的

我们调查了在有或没有糖尿病的情况下，拨打非工作时间初级保健（OHS-PC）的有胸痛症状的男性和女性中，急性冠状动脉综合征（ACS）的患病率差异。

方法

这是在荷兰进行的一项横断面研究。纳入了 2014 年至 2017 年间在荷兰乌得勒支地区拨打 OHS-PC 并出现急性胸痛的患者。我们比较了有糖尿病和无糖尿病的患者。多变量逻辑回归用于确定糖尿病与（i）高紧急分配和（ii）ACS 之间的关系。

结果

在 2195 名有急性胸痛症状的呼叫者中，有 180 名（8.2%）报告患有糖尿病。男性 ACS 的患病率为 15.3%（糖尿病患者为 22.0%），女性为 8.4%（糖尿病患者为 18.8%）。有糖尿病的呼叫者并不经常被分配到高紧急程度（74.4%比 67.8%（OR：1.38；95%CI 0.98-1.96）。然而，这些呼叫者患 ACS 的几率更高（OR：2.17；95%CI 1.47-3.19）。这些差异在男性和女性中相似。