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Diabetes Contributes to Acute Coronary Syndromes Death

Investigators looked at 11 independent, randomized clinical trials conducted during 1997–2006 among 62,036 participants—46,577 with ST-segment elevation myocardial infarction (STEMI) and 15,459 with unstable angina/non-STEMI (UA/NSTEMI). Of the participants, >10,000, or about 17%, had diabetes. The researchers tracked patient mortality at 30 days and at 1 year following treatment for ACS.

Investigators found mortality at 30 days was significantly higher among people with diabetes, regardless of whether they had STEMI or UA/NSTEMI. The risk of death at 30 days was 78% higher among people with diabetes in the UA/NSTEMI group and 40% higher among those with diabetes in the STEMI group. Patients with diabetes also showed increased mortality 1 year after ACS, particularly in the UA/NSTEMI group, but to a slightly lesser degree overall.

"Despite modern therapies for ACS, diabetes confers a significant adverse prognosis, which highlights the importance of aggressive strategies to manage this high-risk population with unstable ischemic heart disease," the authors conclude.

Donahoe SM, Stewart GC, McCabe GH, et al.: Diabetes and mortality following acute coronary syndromes. JAMA 298: 765–775, 2007.[Abstract/Free Full Text]

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