BACKGROUND: Although unstable coronary artery disease is the most common reason for admission to a coronary care unit, the long-term prognosis of patients with this diagnosis is unknown. This is particularly true for patients with diabetes mellitus, who are known to have a high morbidity and mortality after an acute myocardial infarction. METHODS AND RESULTS: Prospectively collected data from 6 different countries in the Organization to Assess Strategies for Ischemic Syndromes (OASIS) registry were analyzed to determine the 2-year prognosis of diabetic and nondiabetic patients who were hospitalized with unstable angina or non-Q-wave myocardial infarction. Overall, 1718 of 8013 registry patients (21%) had diabetes. Diabetic patients had a higher rate of coronary bypass surgery than nondiabetic patients (23% versus 20%, P:<0.001) but had similar rates of catheterization and angioplasty. Diabetes independently predicted mortality (relative risk [RR], 1.57; 95% CI, 1.38 to 1.81; P:<0.001), as well as cardiovascular death, new myocardial infarction, stroke, and new congestive heart failure. Moreover, compared with their nondiabetic counterparts, women had a significantly higher risk than men (RR, 1.98; 95% CI, 1.60 to 2.44; and RR, 1.28; 95% CI, 1.06 to 1.56, respectively). Interestingly, diabetic patients without prior cardiovascular disease had the same event rates for all outcomes as nondiabetic patients with previous vascular disease. CONCLUSIONS: Hospitalization for unstable angina or non-Q-wave myocardial infarction predicts a high 2-year morbidity and mortality; this is especially evident for patients with diabetes. Diabetic patients with no previous cardiovascular disease have the same long-term morbidity and mortality as nondiabetic patients with established cardiovascular disease after hospitalization for unstable coronary artery disease.
BACKGROUND: Although unstable coronary artery disease is the most common reason for admission to a coronary care unit, the long-term prognosis of patients with this diagnosis is unknown. This is particularly true for patients with diabetes mellitus, who are known to have a high morbidity and mortality after an acute myocardial infarction. METHODS AND RESULTS: Prospectively collected data from 6 different countries in the Organization to Assess Strategies for Ischemic Syndromes (OASIS) registry were analyzed to determine the 2-year prognosis of diabetic and nondiabeticpatients who were hospitalized with unstable angina or non-Q-wave myocardial infarction. Overall, 1718 of 8013 registry patients (21%) had diabetes. Diabeticpatients had a higher rate of coronary bypass surgery than nondiabeticpatients (23% versus 20%, P:<0.001) but had similar rates of catheterization and angioplasty. Diabetes independently predicted mortality (relative risk [RR], 1.57; 95% CI, 1.38 to 1.81; P:<0.001), as well as cardiovascular death, new myocardial infarction, stroke, and new congestive heart failure. Moreover, compared with their nondiabetic counterparts, women had a significantly higher risk than men (RR, 1.98; 95% CI, 1.60 to 2.44; and RR, 1.28; 95% CI, 1.06 to 1.56, respectively). Interestingly, diabeticpatients without prior cardiovascular disease had the same event rates for all outcomes as nondiabeticpatients with previous vascular disease. CONCLUSIONS: Hospitalization for unstable angina or non-Q-wave myocardial infarction predicts a high 2-year morbidity and mortality; this is especially evident for patients with diabetes. Diabeticpatients with no previous cardiovascular disease have the same long-term morbidity and mortality as nondiabeticpatients with established cardiovascular disease after hospitalization for unstable coronary artery disease.
Authors: Whady Hueb; Neuza Lopes; Paulo R Soares; Bernard J Gersh; Eduardo Gomes Lima; Ricardo D Oliveira Vieira; Cibele Larrosa Garzillo; Rosa Rhami Garcia; Alexandre Costa Pereira; Celia Maria Strunz; Claudio Meneguetti; Jeane Tsutsui; Jose Parga; Pedro Lemos; Alexandre Hueb; Augusto Ushida; Raul Maranhão; Dalton A Chamone; Jose Af Ramires Journal: BMC Cardiovasc Disord Date: 2010-09-29 Impact factor: 2.298
Authors: Vasile I Pavlov; Laura R La Bonte; William M Baldwin; Maciej M Markiewski; John D Lambris; Gregory L Stahl Journal: Am J Pathol Date: 2011-11-08 Impact factor: 4.307
Authors: T S Fergus; R Fazel; J Fang; S Chetcuti; D E Smith; E Kline-Rogers; K Munir; K A Eagle; D Mukherjee Journal: Heart Date: 2004-09 Impact factor: 5.994
Authors: Donna Chelle V Morales; Sanjeev P Bhavnani; Alan W Ahlberg; Raja C Pullatt; Deborah M Katten; Donna M Polk; Gary V Heller Journal: J Nucl Cardiol Date: 2017-12-06 Impact factor: 5.952
Authors: Stanley Chia; O Christopher Raffel; Masamichi Takano; Guillermo J Tearney; Brett E Bouma; Ik-Kyung Jang Journal: Diabetes Res Clin Pract Date: 2008-05-05 Impact factor: 5.602