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Undiagnosed diabetes raises risk for death, MI in ACS patients
Patients with high-risk non-ST-segment elevation ACS may benefit from routine screening for undiagnosed diabetes, according to research recently published in American Heart Journal.
Researchers examined data from 8,795 patients with high-risk non-ST-segment elevation ACS enrolled in the EARLY-ACS trial to study the association between diagnosed diabetes and prediabetes with clinical outcomes in this patient population.
Of the total patients, 32.5% were known to have diabetes, 12.2% had undiagnosed diabetes, 10.8% had prediabetes and 44.5% had no diabetes.
When researchers examined the 30-day composite of death or MI, they found that patients with undiagnosed diabetes had worse early outcomes at 30 days compared with patients without diabetes (OR=1.28; 95% CI, 1.05-1.57); this observation was driven primarily by higher 30-day mortality (OR=1.65; 95% CI, 1.09-2.48). Patients with diagnosed diabetes also had greater 30-day mortality risk compared with no diabetes (OR=1.4; 95% CI, 1.01-1.93). Patients with prediabetes had similar event rates as patients with no diabetes. At 1 year, presence of diabetes was associated with higher 1-year mortality rates compared with no diabetes (HR=1.38; 95% CI, 1.13-1.67); the same trend was not observed among patients with undiagnosed diabetes or prediabetes, according to the study abstract
In addition, patients with undiagnosed diabetes were at greater risk for bleeding, according to a press release.
“Undiagnosed diabetes and prediabetes are common among patients presenting with high-risk non-ST-segment elevation ACS. Both undiagnosed and known diabetes were associated with worse short-term outcomes, which in general were not observed for patients with prediabetes. Known diabetes was associated with greater 1-year mortality, but prediabetes and undiagnosed diabetes were not. These observations indicate that routine screening for undiagnosed diabetes may be useful since these patients seem to have worse short-term outcomes and deserve consideration of alternative management strategies,” the researchers wrote.
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.