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

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 accordi...

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Detalles Bibliográficos
Autores: Díez-Villanueva, Pablo, García-Acuña, Jose María, Raposeiras-Roubin, Sergio|||0000-0002-6462-4715, Barrabés, José A|||0000-0001-7062-6277, Cordero, Alberto|||0000-0003-0000-7109, Martínez-Sellés, Manuel|||0000-0003-0289-6229, Bardají, Alfredo|||0000-0003-1900-6974, Marín, Francisco|||0000-0001-7246-7708, Ruiz Nodar, Juan Miguel|||0000-0002-8480-0835, Vicente-Ibarra, Nuria, Alonso Salinas, Gonzalo L.|||0000-0001-5914-8526, Cid-Álvarez, Belén, Abu-Assi, Emad|||0000-0003-1568-3118, Formiga, Frances, Núñez, Julio|||0000-0003-1672-7119, Núñez, Eduardo, Ariza-Solé, Albert|||0000-0002-0819-6656, Sanchis, Juan|||0000-0003-0797-8709
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:293128
Acceso en línea:https://ddd.uab.cat/record/293128
https://dx.doi.org/urn:doi:10.3390/jcm10194403
Access Level:acceso abierto
Palabra clave:Diabetes mellitus
Elderly
Non-ST-segment elevation acute coronary syndromes
Women
Descripción
Sumario: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.

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