Diabetes Contributes to Acute Coronary Syndromes Death

Type 2 diabetes substantially increases the risk of death from acute coronary syndromes (ACS), which include coronary artery disease, angina, and heart attack (myocardial infarction), according to an analysis of clinical trials pooled from the Thrombolysis in Myocardial Infarction (TIMI) Study Group.

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.