Document Detail


Impact of diabetic status on the hyperglycemia-induced adverse risk of short term outcomes in hospitalized patients with acute coronary syndromes in the Middle East: findings from the Gulf registry of Acute Coronary Events (Gulf RACE).
MedLine Citation:
PMID:  20852085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: While glucose levels on admission are clearly a much stronger predictor of short term adverse outcomes than diabetes status, there is a paucity of data on how diabetes status impacts the hyperglycemia-induced increased risk.
METHODS: 2786 patients admitted to the hospital with acute coronary syndrome (ACS) and diabetic level hyperglycemia (random >11.1 mmol/L or fasting >7 mmol/L) were identified from a Gulf registry of ACS. We divided the cohort into two groups. Those who were previously known to have diabetes mellitus were identified as the known diabetes group, and the non-diabetic group included those without a previous diabetes diagnosis. We used logistic regression models to assess the effect of glycemic status on hospital mortality and other patient outcomes including heart failure, stroke, recurrent ischemia, cardiogenic shock, major bleeding, and ventilation.
RESULTS: About two-thirds of the hyperglycemics on admission had been diagnosed previously with diabetes. After adjusting for age, in-hospital mortality was significantly higher in the non-diabetic group (OR: 2.36; 95% CI 1.54-3.61) compared to the diabetic group. As for the other outcomes, known diabetes patients had significantly lower incidences of heart failure, cardiogenic shock, and ventilation compared to non-diabetic patients.
CONCLUSION: The effects of hyperglycemia are mitigated by the presence of the chronic diabetic state, and thus, hyperglycemia has a worse effect in those not known to have chronic diabetes. These findings are important and call for further investigation.
Authors:
Lukman Thalib; Mohammad Zubaid; Wafa Rashed; Jassim Al Suwaidi; Wael Almahmeed; Ebaa Alozairi; Muath Alanbaei; Kadhim Sulaiman; Haitham Amin; Ahmed Al-Motarreb
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Publication Detail:
Type:  Journal Article     Date:  2010-09-17
Journal Detail:
Title:  Clinical medicine & research     Volume:  9     ISSN:  1554-6179     ISO Abbreviation:  Clin Med Res     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-28     Completed Date:  2011-07-18     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  101175887     Medline TA:  Clin Med Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-7     Citation Subset:  IM    
Affiliation:
Department of Community Medicine, Faculty of Medicine, Kuwait University, Kuwait. lthalib@hsc.edu.kw
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood,  etiology,  mortality*,  therapy
Adult
Aged
Diabetes Complications / blood,  mortality*,  therapy
Diabetes Mellitus / blood,  mortality*,  therapy
Female
Hospitalization
Humans
Hyperglycemia / blood,  complications,  metabolism*,  therapy
Kuwait / epidemiology
Male
Middle Aged
Registries*
Comments/Corrections

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