Diabetes and adverse cardiovascular outcomes in patients with acute coronary syndrome - Data from Taiwan's acute coronary syndrome full spectrum data registry

Cheng Chun Wei, Kou Gi Shyu, Jun Jack Cheng, Hei Ming Lo, Chiung Zuan Chiu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Diabetes mellitus (DM) is a major public health problem in Taiwan and is associated with poor outcomes in patients with coronary artery disease. However, the role of DM in outcomes for patients with acute coronary syndrome (ACS) has not been clearly defined in Taiwan. This study utilized the Taiwan ACS registry, and characterized the clinical features, risk factors, hospital therapies, hospital outcomes, and events within one year post-discharge to identify the effect of DMon adverse cardiovascular outcomes in ACS patients. Methods: A total of 3183 patients were enrolled from a Taiwan nationwide registry, from October 2008 to January 2010. We compared these ACS patients with and without DM in terms of baseline demographics, clinical presentation, risk factors,medical treatment, intervention, and outcomes in the following 12 months. The primary endpoint was a composite outcome that included death, re-myocardial infarction and stroke within a 12-month period. The secondary endpoint consisted of the combined results of death, re-myocardial infarction, stroke, re-vascularization, and re-hospitalization over 12 months. Results: Overall, 2766 (86.8%) ACS patients were analyzed in this study. Of that total, 1000 (36%) of them were diabetes patients. Over the course of one year of follow-up, the DM patients had higher probabilities of all-cause death (10.1% vs. 6.06%, p <0.05), for both primary outcomes (15.7% vs. 10.93%, p <0.05) and secondary outcomes (51.6% vs. 42.41%, p <0.05). Logistic regression analysis showed that patients in the DMgroupwere at a higher risk of all-cause death and the primary outcomes, after adjusting the confounding variables (odds ratio was 1.9 and 1.6 respectively, p <0.01). For those patients suffering from primary outcomes, themean survival time was 34.7 ± 10.4 days in the Non-DM group and 33.3 ± 11.8 days in the DM group (p <0.05). The log rank test showed the two survival curves were significantly distinctive (p <0.05). Cox regression analysis showed the odds ratio for all-cause death and the primary outcomes were 1.66 and 1.5, respectively (p <0.05). Conclusions: Compared to patients without DM, ACS patients with diabetes had significantly worse outcomes in terms of all-cause death and the combined results for death, re-infarction and stroke.

Original languageEnglish
Pages (from-to)31-38
Number of pages8
JournalActa Cardiologica Sinica
Volume32
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Acute Coronary Syndrome
Taiwan
Registries
Diabetes Mellitus
Cause of Death
Stroke
Odds Ratio
Myocardial Infarction
Regression Analysis
Confounding Factors (Epidemiology)
Survival
Infarction
Coronary Artery Disease
Hospitalization
Public Health
Logistic Models
Demography

Keywords

  • Acute coronary syndrome
  • Diabetes mellitus
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Diabetes and adverse cardiovascular outcomes in patients with acute coronary syndrome - Data from Taiwan's acute coronary syndrome full spectrum data registry. / Wei, Cheng Chun; Shyu, Kou Gi; Cheng, Jun Jack; Lo, Hei Ming; Chiu, Chiung Zuan.

In: Acta Cardiologica Sinica, Vol. 32, No. 1, 01.01.2016, p. 31-38.

Research output: Contribution to journalArticle

Wei, Cheng Chun ; Shyu, Kou Gi ; Cheng, Jun Jack ; Lo, Hei Ming ; Chiu, Chiung Zuan. / Diabetes and adverse cardiovascular outcomes in patients with acute coronary syndrome - Data from Taiwan's acute coronary syndrome full spectrum data registry. In: Acta Cardiologica Sinica. 2016 ; Vol. 32, No. 1. pp. 31-38.
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AU - Chiu, Chiung Zuan

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N2 - Background: Diabetes mellitus (DM) is a major public health problem in Taiwan and is associated with poor outcomes in patients with coronary artery disease. However, the role of DM in outcomes for patients with acute coronary syndrome (ACS) has not been clearly defined in Taiwan. This study utilized the Taiwan ACS registry, and characterized the clinical features, risk factors, hospital therapies, hospital outcomes, and events within one year post-discharge to identify the effect of DMon adverse cardiovascular outcomes in ACS patients. Methods: A total of 3183 patients were enrolled from a Taiwan nationwide registry, from October 2008 to January 2010. We compared these ACS patients with and without DM in terms of baseline demographics, clinical presentation, risk factors,medical treatment, intervention, and outcomes in the following 12 months. The primary endpoint was a composite outcome that included death, re-myocardial infarction and stroke within a 12-month period. The secondary endpoint consisted of the combined results of death, re-myocardial infarction, stroke, re-vascularization, and re-hospitalization over 12 months. Results: Overall, 2766 (86.8%) ACS patients were analyzed in this study. Of that total, 1000 (36%) of them were diabetes patients. Over the course of one year of follow-up, the DM patients had higher probabilities of all-cause death (10.1% vs. 6.06%, p <0.05), for both primary outcomes (15.7% vs. 10.93%, p <0.05) and secondary outcomes (51.6% vs. 42.41%, p <0.05). Logistic regression analysis showed that patients in the DMgroupwere at a higher risk of all-cause death and the primary outcomes, after adjusting the confounding variables (odds ratio was 1.9 and 1.6 respectively, p <0.01). For those patients suffering from primary outcomes, themean survival time was 34.7 ± 10.4 days in the Non-DM group and 33.3 ± 11.8 days in the DM group (p <0.05). The log rank test showed the two survival curves were significantly distinctive (p <0.05). Cox regression analysis showed the odds ratio for all-cause death and the primary outcomes were 1.66 and 1.5, respectively (p <0.05). Conclusions: Compared to patients without DM, ACS patients with diabetes had significantly worse outcomes in terms of all-cause death and the combined results for death, re-infarction and stroke.

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KW - Acute coronary syndrome

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