AI Article Synopsis
- There is a growing interest in non-invasive methods to detect subclinical atherosclerosis in order to identify patients at high risk for cardiovascular events, particularly in those with diabetes mellitus (DM) and peripheral arterial disease (PAD) during acute coronary syndrome (ACS).
- A study involving 1,410 ACS patients found that the prevalence of PAD was significantly higher in those with DM (41.5%) compared to those without (30.6%), and patients with both conditions faced more in-hospital cardiac complications and a potential increase in mortality.
- The combination of DM and PAD serves as a marker for identifying patients at greater risk, while in patients without PAD, DM was linked to three-vessel coronary disease, but this association did not hold in patients
Article Abstract
Background: There is an increasing interest in the use of non-invasive methods for the detection of subclinical atherosclerosis to better identify patients with high risk of cardiovascular events The presence of diabetes mellitus (DM) and peripheral arterial disease (PAD) is associated with increased risk of events but their value in the acute coronary syndrome (ACS) patient has not been ascertained.
Methods: We performed a subanalysis of the PAMISCA study, designed to investigate the prevalence of PAD in patients admitted to Spanish hospitals with a diagnosis of an ACS.
Results: A total of 1410 patients were analysed (71.4% men, age 66 +/- 11.9 years, 35% DM). The prevalence of PAD was higher in DM vs. no-DM (41.5% vs. 30.6% respectively, p < 0.001). Patients with PAD and DM had more in-hospital cardiac complications such as atrial fibrillation/flutter, recurrent myocardial ischaemia and heart failure and a trend towards higher in-hospital mortality (p = 0.08). Non-DM patients with PAD and DM without PAD shared similar cardiac complications and the group without neither PAD nor DM had the best prognosis. In patients without PAD, DM was an independent predictor of three-vessel coronary disease (OR 1.6; 95% CI: 1.1-2.5, p < 0.05) after adjustment by age, sex, low density lipoproteins (LDL), smoking and the previous myocardial infarction. However, in PAD patients, DM failed to be an independent risk factor in the multivariate analysis (OR 1.0; 95% CI 0.6-1.6, p < 0.05).
Conclusions: The concurrence of DM and PAD helps identify patients with an adverse risk profile.
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| http://dx.doi.org/10.1111/j.1742-1241.2009.02121.x | DOI Listing |
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