TY - JOUR
T1 - Impact of diabetic status on the hyperglycemia-induced adverse risk of short term outcomes in hospitalized patients with acute coronary syndromes in the middle east
T2 - Findings from the gulf registry of acute coronary events (Gulf RACE)
AU - Thalib, Lukman
AU - Zubaid, Mohammad
AU - Rashed, Wafa
AU - Suwaidi, Jassim Al
AU - Almahmeed, Wael
AU - Al Ozairi, Ebaa
AU - Alanbaei, Muath
AU - Sulaiman, Kadhim
AU - Amin, Haitham
AU - Al-Motarreb, Ahmed
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Background: While glucose levels on admission are clearly a much stronger predictor of short term adverse outcomes than diabetes status, there is a paucity of data on how diabetes status impacts the hyperglycemia-induced increased risk. Methods: 2786 patients admitted to the hospital with acute coronary syndrome (ACS) and diabetic level hyperglycemia (random >11.1 mmol/L or fasting >7 mmol/L) were identified from a Gulf registry of ACS. We divided the cohort into two groups. Those who were previously known to have diabetes mellitus were identified as the known diabetes group, and the non-diabetic group included those without a previous diabetes diagnosis. We used logistic regression models to assess the effect of glycemic status on hospital mortality and other patient outcomes including heart failure, stroke, recurrent ischemia, cardiogenic shock, major bleeding, and ventilation. Results: About two-thirds of the hyperglycemics on admission had been diagnosed previously with diabetes. After adjusting for age, in-hospital mortality was significantly higher in the non-diabetic group (OR: 2.36; 95% CI 1.54-3.61) compared to the diabetic group. As for the other outcomes, known diabetes patients had significantly lower incidences of heart failure, cardiogenic shock, and ventilation compared to non-diabetic patients. Conclusion: The effects of hyperglycemia are mitigated by the presence of the chronic diabetic state, and thus, hyperglycemia has a worse effect in those not known to have chronic diabetes. These findings are important and call for further investigation.
AB - Background: While glucose levels on admission are clearly a much stronger predictor of short term adverse outcomes than diabetes status, there is a paucity of data on how diabetes status impacts the hyperglycemia-induced increased risk. Methods: 2786 patients admitted to the hospital with acute coronary syndrome (ACS) and diabetic level hyperglycemia (random >11.1 mmol/L or fasting >7 mmol/L) were identified from a Gulf registry of ACS. We divided the cohort into two groups. Those who were previously known to have diabetes mellitus were identified as the known diabetes group, and the non-diabetic group included those without a previous diabetes diagnosis. We used logistic regression models to assess the effect of glycemic status on hospital mortality and other patient outcomes including heart failure, stroke, recurrent ischemia, cardiogenic shock, major bleeding, and ventilation. Results: About two-thirds of the hyperglycemics on admission had been diagnosed previously with diabetes. After adjusting for age, in-hospital mortality was significantly higher in the non-diabetic group (OR: 2.36; 95% CI 1.54-3.61) compared to the diabetic group. As for the other outcomes, known diabetes patients had significantly lower incidences of heart failure, cardiogenic shock, and ventilation compared to non-diabetic patients. Conclusion: The effects of hyperglycemia are mitigated by the presence of the chronic diabetic state, and thus, hyperglycemia has a worse effect in those not known to have chronic diabetes. These findings are important and call for further investigation.
KW - Acute coronary syndrome
KW - Adverse events
KW - Diabetes
KW - Hyperglycemia
UR - http://www.scopus.com/inward/record.url?scp=79953280082&partnerID=8YFLogxK
U2 - 10.3121/cmr.2010.946
DO - 10.3121/cmr.2010.946
M3 - Article
C2 - 20852085
AN - SCOPUS:79953280082
VL - 9
SP - 32
EP - 37
JO - Clinical Medicine and Research
JF - Clinical Medicine and Research
SN - 1539-4182
IS - 1
ER -