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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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Autores principales: Díez-Villanueva, Pablo, García-Acuña, Jose María, Raposeiras-Roubin, Sergio, Barrabés, Jose A., Cordero, Alberto, Martínez-Sellés, Manuel, Bardají, Alfredo, Marín, Francisco, Ruiz-Nodar, Juan M., Vicente-Ibarra, Nuria, Alonso Salinas, Gonzalo L., Cid-Alvárez, Belén, Abu Assi, Emad, Formiga, Frances, Núñez, Julio, Núñez, Eduardo, Ariza-Solé, Albert, Sanchis, Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509190/
https://www.ncbi.nlm.nih.gov/pubmed/34640420
http://dx.doi.org/10.3390/jcm10194403
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author Díez-Villanueva, Pablo
García-Acuña, Jose María
Raposeiras-Roubin, Sergio
Barrabés, Jose A.
Cordero, Alberto
Martínez-Sellés, Manuel
Bardají, Alfredo
Marín, Francisco
Ruiz-Nodar, Juan M.
Vicente-Ibarra, Nuria
Alonso Salinas, Gonzalo L.
Cid-Alvárez, Belén
Abu Assi, Emad
Formiga, Frances
Núñez, Julio
Núñez, Eduardo
Ariza-Solé, Albert
Sanchis, Juan
author_facet Díez-Villanueva, Pablo
García-Acuña, Jose María
Raposeiras-Roubin, Sergio
Barrabés, Jose A.
Cordero, Alberto
Martínez-Sellés, Manuel
Bardají, Alfredo
Marín, Francisco
Ruiz-Nodar, Juan M.
Vicente-Ibarra, Nuria
Alonso Salinas, Gonzalo L.
Cid-Alvárez, Belén
Abu Assi, Emad
Formiga, Frances
Núñez, Julio
Núñez, Eduardo
Ariza-Solé, Albert
Sanchis, Juan
author_sort Díez-Villanueva, Pablo
collection PubMed
description 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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spelling pubmed-85091902021-10-13 Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome Díez-Villanueva, Pablo García-Acuña, Jose María Raposeiras-Roubin, Sergio Barrabés, Jose A. Cordero, Alberto Martínez-Sellés, Manuel Bardají, Alfredo Marín, Francisco Ruiz-Nodar, Juan M. Vicente-Ibarra, Nuria Alonso Salinas, Gonzalo L. Cid-Alvárez, Belén Abu Assi, Emad Formiga, Frances Núñez, Julio Núñez, Eduardo Ariza-Solé, Albert Sanchis, Juan J Clin Med Article 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. MDPI 2021-09-26 /pmc/articles/PMC8509190/ /pubmed/34640420 http://dx.doi.org/10.3390/jcm10194403 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Díez-Villanueva, Pablo
García-Acuña, Jose María
Raposeiras-Roubin, Sergio
Barrabés, Jose A.
Cordero, Alberto
Martínez-Sellés, Manuel
Bardají, Alfredo
Marín, Francisco
Ruiz-Nodar, Juan M.
Vicente-Ibarra, Nuria
Alonso Salinas, Gonzalo L.
Cid-Alvárez, Belén
Abu Assi, Emad
Formiga, Frances
Núñez, Julio
Núñez, Eduardo
Ariza-Solé, Albert
Sanchis, Juan
Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title_full Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title_fullStr Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title_full_unstemmed Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title_short Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome
title_sort prognosis impact of diabetes in elderly women and men with non-st elevation acute coronary syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509190/
https://www.ncbi.nlm.nih.gov/pubmed/34640420
http://dx.doi.org/10.3390/jcm10194403
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