Κατεύθυνση Σακχαρώδης Διαβήτης και Παχυσαρκία
Library of the School of Health Sciences

2020-12-29

2020

Siafarikas Christos

Τεντολούρης Νικόλαος,Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μακρυλάκης Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κόκκινος Αλέξανδρος , Αναπληρωτής Καθηγητής, Ιατρική Σχολή , ΕΚΠΑ

Αδιάγνωστος και υποθεραπευόμενος Σακχαρώδης Διαβήτης σε ασθενείς με οξύ στεφανιαίο σύνδρομο

Greek

Undiagnosed and untreated Diabetes mellitus in patients with acute coronary syndrome

Diabetes mellitus type 2 and other modifiable risk factors among patients hospitalized for acute coronary syndrome in a tertiary hospital during one-year period.
Introduction: Acute coronary syndrome (ACS) continues to be associated with significant morbidity and mortality despite advances in pharmacological and non-pharmacological treatment. For this reason, it seems that primary and secondary prevention of OSS through aggressive modification of risk factors is the most effective way to reduce the number and severity of ACS and its long-term complications.
Methods: In our prospective study we enrolled and analyzed the clinical characteristics and the outcome of all hospitalized patients with a diagnosis of acute coronary syndrome (ACS) in the cardiology department of our hospital during the annual period 1/7/2019 until 30/6/2020.
Results: 185 patients were hospitalized during this period with a diagnosis of acute coronary syndrome (ACS). The mean age of patients was 65 ± 12 years, while 82% were men. Twenty-nine (16%) presented with unstable angina, 96 (52%) with NSTEMI and 60 (32%) with STEMI. Fifty-seven patients (31%) had a history of diabetes mellitus (DM) and 97 (52%) had a history of dyslipidemia. A history of coronary artery disease (CAD) was pre-existing in 51 (28%) patients, while a history of hypertension in 101 (55%) patients. Based on the previous medical history of CAD and DM, patients were divided into 4 groups [CAD + / DM + (N = 23), CAD + / DM- (N = 28), CAD - / DM + (N = 34), CAD - / DM - (Ν = 100)]. Patients in the four groups differed significantly in the rates of diagnosed and treated dyslipidemia and hypertension, antiplatelet therapy, serum lipid levels and the extent of coronary heart disease. Statin use was independently associated with a history of dyslipidemia (OR: 27.4; 95% CI: 9.6-77.8; P <0.001) and CAD (OR: 11.4, 95% CI: 4.0-32,7; P <0.001), but not DM (OR: 1.4; 95% CI: 0.6-3.4; P = 0.48). The same was true for aspirin, which was independently associated with a history of dyslipidemia (OR: 3.7 95% CI: 1.4-9.6,P = 0.007) and CAD (OR:11.4 95% CI).:4.9-26.3; P <0.001), but not DM (OR: 2.1;95% CI:0.9-4.9;P = 0.09).
Discussion: In the group of diabetic patients without previous ACS, the adjustment of modifiable risk factors as primary prevention is less effective. Although the guidelines recommend moderate-intensity statins for all patients with DM aged 40-75 years without a history of cardiovascular disease and low-dose aspirin in high-risk cardiovascular diabetics, our data suggest that the group of patients with no previous ACS don’t use statin and / or aspirin in the absence of coronary heart disease and dyslipidemia.

Health Sciences

Diabetes mellitus, Acute coronary syndrome, Modifiable risk factors

No

0

Yes

97

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https://pergamos.lib.uoa.gr/uoa/dl/object/2930381