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Diabetes mellitus (DM) is associated with adverse outcomes and the in-hospital outcomes of diabetic patients with acute coronary syndrome (ACS) are less known. This study aims to investigate the relationship between DM and in-hospital outcomes in the setting of ACS patients in China.
A nation-wide registry study, Improving Care for Cardiovascular Disease in China Project - ACS program, was launched in 2014 as a collaborative study of the American Heart Association and Chinese Society of Cardiology, with 150 participating hospitals reporting details of clinical management and outcomes of patients with ACS. Clinical characteristics and in-hospital outcomes were analyzed by prior DM status.
A total of 59456 patients with ACS were enrolled between November 2014 and March 2017, including 37336 (62.8%) ST-segment elevation myocardial infarction (STEMI), 14465 (24.3%) non-ST-segment elevation myocardial infarction (NSTEMI) and 7655 (12.9%) unstable angina pectoris (UAP) patients. Overall, 21.9% of the ACS patients had DM. In-hospital mortality rates for ACS patients with DM was 2.96% compared with 1.73% in those without DM. There was an increased risk of in-hospital mortality in the DM group in the STEMI (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.36 to 1.84, P < 0.001), NSTEMI (OR 1.66, 95% CI 1.32 to 2.10, P < 0.001) and UAP (OR 4.15, 95% CI 1.31 to 13.13, P = 0.02) populations after adjusting for age, sex and other potential confounders.
ACS Patients presenting with DM have a higher in-hospital mortality risk, compared with patients without DM. The aggressive treatment in diabetic patients with ACS is warranted.