Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome

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Díez Villanueva, Pablo and García Acuña, Jose María and Raposeiras Roubin, Sergio and Barrabés, Jose A. and Cordero, Alberto and Martínez Sellés d'Oliveira Soares, Manuel and Bardají, Alfredo and Marín, Francisco and Ruiz Nodar, Juan M. and Vicente Ibarra, Nuria and Alonso Salinas, Gonzalo L. and Cid Alvárez, Belén and Abu Assi, Emad and Formiga, Frances and Núñez, Julio and Núñez, Eduardo and Ariza Solé, Albert and Sanchis, Juan (2021) Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome. Journal of Clinical Medicine, 10 (19). p. 4403. ISSN 2077-0383

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Official URL: https://doi.org/10.3390/jcm10194403




Abstract

Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years. The primary end point was one-year all-cause mortality. A total of 7211 patients were included, 2,770 (38.4%) were women, and 39.9% had DM. Compared with the men, the women were older (79.95 ± 5.75 vs. 78.45 ± 5.43 years, p < 0.001) and more often had a history of hypertension (77% vs. 83.1%, p < 0.01). Anemia and chronic kidney disease were both more common in women. On the other hand, they less frequently had a prior history of arteriosclerotic cardiovascular disease or comorbidities such as peripheral artery disease and chronic pulmonary disease. Women showed a worse clinical profile on admission, though an invasive approach and in-hospital revascularization were both more often performed in men (p < 0.001). At a one-year follow-up, 1090 patients (15%) had died, without a difference between sexes. Male sex was an independent predictor of mortality (HR = 1.15, 95% CI 1.01 to 1.32, p = 0.035), and there was a significant interaction between sex and DM (p = 0.002). DM was strongly associated with mortality in women (HR: 1.45, 95% CI = 1.18–1.78; p < 0.001), but not in men (HR: 0.98, 95% CI = 0.84–1.14; p = 0.787). In conclusion, DM is associated with mortality in older women with NSTEACS, but not in men.


Item Type:Article
Uncontrolled Keywords:elderly; non-ST-segment elevation acute coronary syndromes; women; diabetes mellitus
Subjects:Medical sciences > Medicine > Dietetics and Nutrition
Medical sciences > Medicine > Endocrinology
ID Code:71290
Deposited On:23 Mar 2022 17:22
Last Modified:24 Mar 2022 08:10

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