Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
Díez-Villanueva, Pablo (Hospital Universitario de la Princesa (Madrid))
García-Acuña, Jose María (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Raposeiras-Roubin, Sergio (Hospital Álvaro Cunqueiro (Vigo))
Barrabés, José A (Hospital Universitari Vall d'Hebron)
Cordero, Alberto (Hospital Clínico Universitario de San Juan)
Martínez-Sellés, Manuel (Hospital General Universitario Gregorio Marañón)
Bardají, Alfredo (Hospital Universitari Joan XXIII de Tarragona)
Marín, Francisco (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Ruiz Nodar, Juan Miguel (Hospital General Universitario de Alicante (Alacant, País Valencià))
Vicente-Ibarra, Nuria (Hospital General Universitario de Elche)
Alonso Salinas, Gonzalo L. (Hospital Universitario Ramón y Cajal (Madrid))
Cid-Álvarez, Belén (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Abu-Assi, Emad (Hospital Álvaro Cunqueiro (Vigo))
Formiga, Frances (Hospital Universitari de Bellvitge)
Núñez, Julio (Hospital Clínic Universitari (València))
Núñez, Eduardo (Hospital Clínic Universitari (València))
Ariza-Solé, Albert (Hospital Universitari de Bellvitge)
Sanchis, Juan (Hospital Clínic Universitari (València))
Universitat Autònoma de Barcelona

Date:	2021
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.
Grants:	Ministerio de Economía y Competitividad CB16/11/00420
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diabetes mellitus ; Elderly ; Non-ST-segment elevation acute coronary syndromes ; Women
Published in:	Journal of clinical medicine, Vol. 10 (september 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10194403
PMID: 34640420

9 p, 630.1 KB

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