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Diabetics Fare Worse After Acute Coronary Syndrome

Diabetes is independently associated with higher 30-day and one-year mortality rates

TUESDAY, Aug. 14 (HealthDay News) -- In patients with acute coronary syndrome, 30-day and one-year mortality rates are significantly higher among those who have diabetes compared to those who do not, researchers report in the Aug. 15 issue of the Journal of the American Medical Association.

Elliott M. Antman, M.D., of Brigham and Women's Hospital in Boston, and colleagues pooled data from 11 clinical trials involving 62,036 patients, including 46,577 with ST-segment elevation myocardial infarction (STEMI) and 15,459 with unstable angina/non-STEMI. A total of 10,613 patients (17.1 percent) had diabetes.

The researchers found that diabetes was independently associated with higher 30-day mortality after unstable angina/non-STEMI (odds ratio, 1.78) or STEMI (OR, 1.40). They also found that diabetes was associated with significantly higher one-year mortality after unstable angina/non-STEMI (hazard ratio, 1.65) or STEMI (HR, 1.22).

"Current strategies are insufficient to ameliorate the adverse impact of diabetes," the authors conclude. "Given the increasing burden of cardiovascular disease attributable to diabetes worldwide, our study highlights the need for a major research effort to identify aggressive new strategies to manage unstable ischemic heart disease among this high-risk population."

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