Diabetes Ups Risk of MACE in Acute Coronary Syndromes
THURSDAY, Oct. 19, 2017 -- For patients with acute coronary syndromes (ACS), diabetes mellitus (DM), but not pre-DM, is associated with an increased risk of major adverse cardiac events (MACE), according to a study published online Oct. 18 in the Journal of the American College of Cardiology.
Serdar Farhan, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the impact of pre-DM on coronary plaque characteristics and ischemic outcome in patients with ACS. Participants underwent quantitative coronary angiography, grayscale intravascular ultrasound (IVUS), and radiofrequency IVUS after successful percutaneous coronary intervention. Patients were categorized based on their glucometabolic status as normal glucose metabolism (NGM; 162 patients), pre-DM (202 patients), and DM (183 patients).
The researchers found that there were no significant between-group differences with respect to IVUS findings indicative of vulnerable plaques. Compared to patients with pre-DM or NGM, patients with DM had a higher crude rate of MACE (25.9 versus 16.3 and 16.1 percent; P = 0.03 and 0.02, respectively). Using NGM as the reference group, DM, but not pre-DM, was correlated with increased risk of MACE in an adjusted model (hazard ratios, 2.2 [95 percent confidence interval, 1.25 to 3.86; P = 0.006] and 1.29 [95 percent confidence interval, 0.71 to 2.33; P = 0.41]).
"DM but not pre-DM is associated with an increased risk of MACE," the authors write. "Thus, preventing patients from progressing from pre-DM to DM is important."
Several authors disclosed financial ties to the biopharmaceutical and medical device industries.
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Posted: October 2017