AIMS: Both diabetes mellitus (DM) and hyperglycaemia are known to predict outcome after acute coronary syndrome (ACS). Recent work has suggested women with DM have greater baseline cardiovascular risk and poorer outcome after ACS. The interaction between sex and abnormal glucose homoeostasis in patients without diabetes is unexplored; we aimed to assess this relationship. METHODS AND RESULTS: Retrospective analysis of data from a prospective cohort study of 1575 patients with a confirmed ACS and no previous diagnosis of DM in 11 UK hospitals. Multivariable analysis was performed to assess the value of clinical variables, including hyperglycaemia and sex, in predicting 2 year all-cause mortality. Sex and hyperglycaemia interacted in predicting mortality. In men, mortality risk increased more steeply with incremental levels of glycaemia than in women (glucose > or =11.1 mmol/l, hazard ratio, 2.19; 95% confidence interval, 1.2-4.0). In both sex groups increasing glycaemia predicted mortality at levels currently not recommended for acute therapeutic intervention (7.8-11.0 mmol/l). CONCLUSIONS: In patients not known to have diabetes, hyperglycaemia is a concentration-dependent predictor of long-term mortality after ACS; this predictive value is stronger in men than women.
AIMS: Both diabetes mellitus (DM) and hyperglycaemia are known to predict outcome after acute coronary syndrome (ACS). Recent work has suggested women with DM have greater baseline cardiovascular risk and poorer outcome after ACS. The interaction between sex and abnormal glucose homoeostasis in patients without diabetes is unexplored; we aimed to assess this relationship. METHODS AND RESULTS: Retrospective analysis of data from a prospective cohort study of 1575 patients with a confirmed ACS and no previous diagnosis of DM in 11 UK hospitals. Multivariable analysis was performed to assess the value of clinical variables, including hyperglycaemia and sex, in predicting 2 year all-cause mortality. Sex and hyperglycaemia interacted in predicting mortality. In men, mortality risk increased more steeply with incremental levels of glycaemia than in women (glucose > or =11.1 mmol/l, hazard ratio, 2.19; 95% confidence interval, 1.2-4.0). In both sex groups increasing glycaemia predicted mortality at levels currently not recommended for acute therapeutic intervention (7.8-11.0 mmol/l). CONCLUSIONS: In patients not known to have diabetes, hyperglycaemia is a concentration-dependent predictor of long-term mortality after ACS; this predictive value is stronger in men than women.
Authors: Martin Clodi; Christoph Säly; Friedrich Hoppichler; Michael Resl; Clemens Steinwender; Bernd Eber Journal: Wien Klin Wochenschr Date: 2016-04 Impact factor: 1.704
Authors: Matthew B Kahn; Nadira Y Yuldasheva; Richard M Cubbon; Jessica Smith; Sheikh T Rashid; Hema Viswambharan; Helen Imrie; Afroze Abbas; Adil Rajwani; Amir Aziz; Vivek Baliga; Piruthivi Sukumar; Matthew Gage; Mark T Kearney; Stephen B Wheatcroft Journal: Diabetes Date: 2011-02-11 Impact factor: 9.461
Authors: Julio Yoshio Takada; Rogério Bicudo Ramos; Solange Desiree Avakian; Soane Mota dos Santos; José Antonio Franchini Ramires; Antonio de Pádua Mansur Journal: ScientificWorldJournal Date: 2012-02-01
Authors: Julio Yoshio Takada; Rogério Bicudo Ramos; Larissa Cardoso Roza; Solange Desiree Avakian; José Antonio Franchini Ramires; Antonio de Pádua Mansur Journal: Cardiovasc Diabetol Date: 2012-05-17 Impact factor: 9.951