Miquel Gual1, Francesc Formiga1, Albert Ariza-Solé2, Ramon López-Palop3, Juan Sanchís4, Francisco Marín5, María T Vidán6, Manuel Martínez-Sellés6,7, Alessandro Sionis8, José C Sánchez-Salado1, Victòria Lorente1, Pablo Díez-Villanueva9, Miquel Vives-Borrás8, Alberto Cordero3, Héctor Bueno10,11, Oriol Alegre1, Emad Abu-Assi12, Àngel Cequier1. 1. Cardiology Department, Bellvitge University Hospital, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. 2. Cardiology Department, Bellvitge University Hospital, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. aariza@bellvitgehospital.cat. 3. Hosptal Universitario San Juan, Alicante, Spain. 4. Hospital Clínico Universitario de Valencia, INCLIVA, Universidad de Valencia, CIBER-CV, Valencia, Spain. 5. Hospital Virgen de la Arrixaca, IMIB-Arrixaca, CIBER-CV, Murcia, Spain. 6. Hospital General Universitario Gregorio Marañón, Madrid, Spain. 7. CIBERCV, Universidad Complutense, Universidad Europea, Madrid, Spain. 8. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 9. Hospital Unversitario La Princesa, Madrid, Spain. 10. Hospital Doce de Octubre, Madrid, Spain. 11. Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain. 12. Hospital Álvaro Cunqueiro, Vigo, Spain.
Abstract
BACKGROUND: The magnitude of the association between diabetes (DM) and outcomes in elderly patients with acute coronary syndromes (ACS) is controversial. No study assessed the prognostic impact of DM according to frailty status in these patients. METHODS: The LONGEVO-SCA registry included unselected ACS patients aged ≥ 80 years. Frailty was assessed by the FRAIL scale. We evaluated the impact of previous known DM on the incidence of death or readmission at 6 months according to status frailty by the Cox regression method. RESULTS: A total of 532 patients were included. Mean age was 84.3 years, and 212 patients (39.8%) had previous DM diagnosis. Patients with DM had more comorbidities and higher prevalence of frailty (33% vs 21.9%, p = 0.002). The incidence of death or readmission at 6 months was higher in patients with DM (HR 1.52, 95% CI 1.12-2.05, p 0.007), but after adjusting for potential confounders this association was not significant. The association between DM and outcomes was not significant in robust patients, but it was especially significant in patients with frailty [HR 1.72 (1.05-2.81), p = 0.030, p value for interaction = 0.049]. CONCLUSIONS: About 40% of elderly patients with ACS had previous known DM diagnosis. The association between DM and outcomes was different according to frailty status.
BACKGROUND: The magnitude of the association between diabetes (DM) and outcomes in elderly patients with acute coronary syndromes (ACS) is controversial. No study assessed the prognostic impact of DM according to frailty status in these patients. METHODS: The LONGEVO-SCA registry included unselected ACS patients aged ≥ 80 years. Frailty was assessed by the FRAIL scale. We evaluated the impact of previous known DM on the incidence of death or readmission at 6 months according to status frailty by the Cox regression method. RESULTS: A total of 532 patients were included. Mean age was 84.3 years, and 212 patients (39.8%) had previous DM diagnosis. Patients with DM had more comorbidities and higher prevalence of frailty (33% vs 21.9%, p = 0.002). The incidence of death or readmission at 6 months was higher in patients with DM (HR 1.52, 95% CI 1.12-2.05, p 0.007), but after adjusting for potential confounders this association was not significant. The association between DM and outcomes was not significant in robust patients, but it was especially significant in patients with frailty [HR 1.72 (1.05-2.81), p = 0.030, p value for interaction = 0.049]. CONCLUSIONS: About 40% of elderly patients with ACS had previous known DM diagnosis. The association between DM and outcomes was different according to frailty status.