Guissé Papa Momar, Sall Sokhna Awa Balla, Niang Tacko, Doucouré Thierno Safaïou, Mboup Mouhamed Cherif, Ngaïdé Aliou Alassane, Mbaye Alassane
Hôpital Principal de Dakar, Sénégal.
Centre Hospitalier National de Pikine, Sénégal.
Ann Cardiol Angeiol (Paris). 2024 Jun;73(3):101767. doi: 10.1016/j.ancard.2024.101767. Epub 2024 May 8.
Diabetes Mellitus is a strong cardiovascular risk factor in which acute coronary syndromes (ACS) are thought to have a particular feature. We aimed to determine the characteristics of acute coronary syndromes in diabetics compared with non-diabetics patients.
We carried out a prospective, descriptive and analytical study comparing diabetic and non-diabetic patients admitted for acute coronary syndrome to the cardiology department of Idrissa Pouye general hospital over a period of one year by studying socio-demographic, clinical, paraclinical, therapeutic and evolutionary parameters. We performed a multivariable logistic regression analysis to identify factors associated with chest pain and triple vessels disease.
Our study included 139 patients, 61 with diabetes (44%) and 78 without diabetes (56%). Among diabetics, there was a predominance of women (p = 0.0001) in contrast to non-diabetics. The mean age was 62.7 ± 10.8 years in diabetics and 56.9 ± 13.5 years in non-diabetics (p = 0.006). Chest pain was found in 88.5% of diabetics and 97.4% of non-diabetics (p = 0.03). The mean HbA1c in diabetics was 9.4 ± 3.3%. ST elevation acute coronary syndrome was predominant in both groups. The mean GRACE score was 147 ± 29 in diabetics and 132 ± 28 in non-diabetics (p = 0.003). In multivariable analysis, only diabetes was associated with triple vessels disease (aOR (IC à 95%): 2,60 (1.29-6.83); p = 0.042). A total of 31% of diabetics and 43% of nondiabetics undergoes cardiac revascularization. There was no difference between the two groups in terms of complications. The mortality was 6.6% and 3.8% respectively among diabetics and non-diabetics (p = 0.49).
According to our study, diabetes is frequently encountered during acute coronary syndromes. It also shows that diabetics are more likely to be female and older, with more atypical symptoms and more severe coronary disease.
糖尿病是一种重要的心血管危险因素，急性冠状动脉综合征（ACS）被认为具有其独特特征。我们旨在确定糖尿病患者与非糖尿病患者相比急性冠状动脉综合征的特征。
我们进行了一项前瞻性、描述性和分析性研究，通过研究社会人口统计学、临床、辅助检查、治疗及病情演变参数，比较了在伊德里斯萨·普耶综合医院心内科住院一年的急性冠状动脉综合征糖尿病患者与非糖尿病患者。我们进行了多变量逻辑回归分析以确定与胸痛和三支血管病变相关的因素。
我们的研究纳入了139例患者，其中61例患有糖尿病（44%），78例无糖尿病（56%）。与非糖尿病患者相比，糖尿病患者中女性占多数（p = 0.0001）。糖尿病患者的平均年龄为62.7±10.8岁，非糖尿病患者为56.9±13.5岁（p = 0.006）。88.5%的糖尿病患者和97.4%的非糖尿病患者出现胸痛（p = 0.03）。糖尿病患者的平均糖化血红蛋白（HbA1c）为9.4±3.3%。两组中ST段抬高型急性冠状动脉综合征均占主导。糖尿病患者的平均GRACE评分是147±29，非糖尿病患者为132±28（p = 0.003）。在多变量分析中，只有糖尿病与三支血管病变相关（调整后比值比（95%置信区间）：2.60（1.29 - 6.83）；p = 0.042）。共有31%的糖尿病患者和43%的非糖尿病患者接受了心脏血运重建。两组在并发症方面无差异。糖尿病患者和非糖尿病患者的死亡率分别为6.6%和3.8%（p = 0.49）。
根据我们的研究，糖尿病在急性冠状动脉综合征中很常见。研究还表明，糖尿病患者更可能为女性且年龄较大，并伴有更多非典型症状和更严重的冠状动脉疾病。
