P6447Prediabetes versus diabetes mellitus in acute coronary syndrome patients: two sides of the same coin

• Published in: European heart journal 2019-10, Vol.40 (Supplement_1)
• Main Authors: Vila Cha Vaz Saleiro, C, Lopes, J, Teixeira, R, Campos, D, Sousa, J P, Puga, L, Ribeiro, J M, Lourenco, C, Costa, M, Goncalves, L
• Format: Article
• Language: English
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehz746.1040

Abstract Background Prediabetic patients are at increased risk of composite cardiovascular (CV) events and all-cause mortality. The impact of prediabetes diagnosis in the context of an acute coronary syndrome (ACS) remains to be determined. Purpose To assess the differences on long-term mortality between well controlled diabetic and prediabetic patients admitted with non-ST elevation ACS. Methods 352 non-ST elevation ACS patients admitted to a single coronary care unit between 2009 and 2016 were included. Clinical, laboratorial and echocardiographic data were evaluated. Two groups were created based on the diabetic status and HBA1c level: Group A (prediabetic patients, HBA1c between 5.7–6.4%) N=229; Group B (diabetic patients, HBA1c ≤7%) N=123. The primary endpoint was long-term all-cause mortality. Kaplan-Meyer survival curves and Cox regression were done. The mean time of follow up was 48±30 months. Results The groups were similar regarding demographics, CV risk factors, ACS type, heart failure diagnosis, peak troponin I, left ventricular (LV) systolic function, multivessel disease and treatment option (PCI, CABG or OMT). On the contrary, well controlled diabetic patients had a higher prevalence of chronic kidney disease (CKD) (27.9% vs 39.0%, P