Impact of diabetes on long-term prognosis in patients with unstable anginaand non-Q-wave myocardial infarction - Results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) registry

Citation
K. Malmberg et al., Impact of diabetes on long-term prognosis in patients with unstable anginaand non-Q-wave myocardial infarction - Results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) registry, CIRCULATION, 102(9), 2000, pp. 1014-1019
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
102
Issue
9
Year of publication
2000
Pages
1014 - 1019
Database
ISI
SICI code
0009-7322(20000829)102:9<1014:IODOLP>2.0.ZU;2-0
Abstract
Background-Although unstable coronary artery disease is the most common rea son for admission to a coronary care unit, the long-term prognosis of patie nts with this diagnosis is unknown. This is particularly true for patients with diabetes mellitus, who are known to have a high morbidity and mortalit y after an acute myocardial infarction. Methods and Results-Prospectively collected data from 6 different countries in the Organization to Assess Strategies for Ischemic Syndromes (OASIS) re gistry were analyzed to determine the 2-year prognosis of diabetic and nond iabetic patients who were hospitalized with unstable angina or non-Q-wave m yocardial infarction. Overall, 1718 of 8013 registry patients (21%) had dia betes. Diabetic patients had a higher rate of coronary bypass surgery than nondiabetic patients (23% versus 20%, P<0.001) but had similar rates of cat heterization and angioplasty. Diabetes independently predicted mortality (r elative risk [RR], 1.57; 95% CI, 1.38 to 1.81; P<0.001), as well as cardiov ascular death, new myocardial infarction, stroke, and new congestive heart failure. Moreover, compared with their nondiabetic counterparts, women had a significantly higher risk than men (RR, 1.98; 95% CI, 1.60 to 2.44; and R R, 1.38; 95% CI, 1.06 to 1.56, respectively). Interestingly, diabetic patie nts without prior cardiovascular disease had the same event rates for all o utcomes as nondiabetic patients with previous vascular disease. Conclusions-Hospitalization for unstable angina or non-Q-wave myocardial in farction predicts a high 2-year morbidity and mortality; this is especially evident for patients with diabetes. Diabetic patients with no previous car diovascular disease have the same long-term morbidity and mortality as nond iabetic patients with established cardiovascular disease after hospitalizat ion for unstable coronary artery disease.