Clinical implications of diabetes mellitus in patients with acute coronary syndrome: Prognostic role and use of new P2Y 12 receptor inhibitors
We investigated the impact of diabetes mellitus (DM) in acute coronary syndrome (ACS) patients, and the 2-year prognosis based on antiplatelet therapy. This is a prospective and multicenter registry including hospitalized ACS patients. Clinical management and antiplatelet therapy at discharge were r...
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| Veröffentlicht in: | Diabetes research and clinical practice 2022-02, Vol.184, p.109215 |
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| creator | Gil-Perez, Pablo Ruiz-Nodar, Juan Miguel Esteve-Pastor, María Asunción Hortelano, Ignacio Villamía, Beatriz Vicente-Ibarra, Nuria Orenes-Piñero, Esteban Macías, Manuel Jesús Núñez-Martínez, Laura Carrillo, Luna Candela, Elena Véliz-Martínez, Andrea López-García, Cecilia Martínez-Martínez, Juan Gabriel Rivera-Caravaca, José Miguel Marín, Francisco |
| description | We investigated the impact of diabetes mellitus (DM) in acute coronary syndrome (ACS) patients, and the 2-year prognosis based on antiplatelet therapy.
This is a prospective and multicenter registry including hospitalized ACS patients. Clinical management and antiplatelet therapy at discharge were recorded. Bleeding events, all-cause mortality and major adverse cardiovascular events (MACEs) were recorded during 2-years and compared according to DM and the P2Y
receptor inhibitor.
From 1717 ACS patients, 653 (38%) had DM. Diabetic patients were older, more commonly females, with higher prevalence of comorbidities and more conservative management. After excluding antiplatelet monotherapy or oral anticoagulation, clopidogrel was prescribed in 59.6% of DM patients. Cox regression analysis showed that DM was an independent risk factor for MACE (aHR 1.39, 95% CI 1.05-1.83). The use of clopidogrel instead of ticagrelor/prasugrel was also independently associated with MACE (aHR 1.71, 95% CI 1.11-2.63), and all-cause mortality (aHR 2.47, 95% CI 1.23-4.96) in diabetic patients (log-rank p-values |
| doi_str_mv | 10.1016/j.diabres.2022.109215 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed</sourceid><recordid>TN_cdi_pubmed_primary_35085647</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>35085647</sourcerecordid><originalsourceid>FETCH-pubmed_primary_350856473</originalsourceid><addsrcrecordid>eNqFj8tOAzEMRSMk1JbHJ4D8Ax2STOcB2wrEsotuWFWZGbd1lccozqjqT_DNpBKsWd0j2zrWFeJJyUJJVb-cioFMF5ELLbXOs1etqhuxUG2jl63WzVzcMZ-klHW5qmZiXlayrepVsxDfa0ueemOB3GgzJAqeIezhqsSEDA6tpTQxkIcx79EnhjOlI5h-Sgh9iMGbeAG--CEGh2-wieHgAyfqIQaLYPwAE-NV6_EMG_0FSkPEHscUYhYfqaNM_CBu98YyPv7mvXj-eN-uP5fj1DkcdmMkl1_t_gqU_x78AC_zWus</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Clinical implications of diabetes mellitus in patients with acute coronary syndrome: Prognostic role and use of new P2Y 12 receptor inhibitors</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Gil-Perez, Pablo ; Ruiz-Nodar, Juan Miguel ; Esteve-Pastor, María Asunción ; Hortelano, Ignacio ; Villamía, Beatriz ; Vicente-Ibarra, Nuria ; Orenes-Piñero, Esteban ; Macías, Manuel Jesús ; Núñez-Martínez, Laura ; Carrillo, Luna ; Candela, Elena ; Véliz-Martínez, Andrea ; López-García, Cecilia ; Martínez-Martínez, Juan Gabriel ; Rivera-Caravaca, José Miguel ; Marín, Francisco</creator><creatorcontrib>Gil-Perez, Pablo ; Ruiz-Nodar, Juan Miguel ; Esteve-Pastor, María Asunción ; Hortelano, Ignacio ; Villamía, Beatriz ; Vicente-Ibarra, Nuria ; Orenes-Piñero, Esteban ; Macías, Manuel Jesús ; Núñez-Martínez, Laura ; Carrillo, Luna ; Candela, Elena ; Véliz-Martínez, Andrea ; López-García, Cecilia ; Martínez-Martínez, Juan Gabriel ; Rivera-Caravaca, José Miguel ; Marín, Francisco</creatorcontrib><description>We investigated the impact of diabetes mellitus (DM) in acute coronary syndrome (ACS) patients, and the 2-year prognosis based on antiplatelet therapy.
This is a prospective and multicenter registry including hospitalized ACS patients. Clinical management and antiplatelet therapy at discharge were recorded. Bleeding events, all-cause mortality and major adverse cardiovascular events (MACEs) were recorded during 2-years and compared according to DM and the P2Y
receptor inhibitor.
From 1717 ACS patients, 653 (38%) had DM. Diabetic patients were older, more commonly females, with higher prevalence of comorbidities and more conservative management. After excluding antiplatelet monotherapy or oral anticoagulation, clopidogrel was prescribed in 59.6% of DM patients. Cox regression analysis showed that DM was an independent risk factor for MACE (aHR 1.39, 95% CI 1.05-1.83). The use of clopidogrel instead of ticagrelor/prasugrel was also independently associated with MACE (aHR 1.71, 95% CI 1.11-2.63), and all-cause mortality (aHR 2.47, 95% CI 1.23-4.96) in diabetic patients (log-rank p-values < 0.001).
In ACS patients, DM was associated with higher risk of MACE. In such patients, the use of ticagrelor/prasugrel reduced MACE and mortality compared to clopidogrel. Novel P2Y
receptor inhibitors might be used as the first therapeutic choice in these high-risk patients.</description><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2022.109215</identifier><identifier>PMID: 35085647</identifier><language>eng</language><publisher>Ireland</publisher><subject>Acute Coronary Syndrome - drug therapy ; Diabetes Mellitus - chemically induced ; Diabetes Mellitus - drug therapy ; Female ; Humans ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors - therapeutic use ; Prognosis ; Prospective Studies ; Purinergic P2Y Receptor Antagonists - therapeutic use ; Treatment Outcome</subject><ispartof>Diabetes research and clinical practice, 2022-02, Vol.184, p.109215</ispartof><rights>Copyright © 2022 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35085647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gil-Perez, Pablo</creatorcontrib><creatorcontrib>Ruiz-Nodar, Juan Miguel</creatorcontrib><creatorcontrib>Esteve-Pastor, María Asunción</creatorcontrib><creatorcontrib>Hortelano, Ignacio</creatorcontrib><creatorcontrib>Villamía, Beatriz</creatorcontrib><creatorcontrib>Vicente-Ibarra, Nuria</creatorcontrib><creatorcontrib>Orenes-Piñero, Esteban</creatorcontrib><creatorcontrib>Macías, Manuel Jesús</creatorcontrib><creatorcontrib>Núñez-Martínez, Laura</creatorcontrib><creatorcontrib>Carrillo, Luna</creatorcontrib><creatorcontrib>Candela, Elena</creatorcontrib><creatorcontrib>Véliz-Martínez, Andrea</creatorcontrib><creatorcontrib>López-García, Cecilia</creatorcontrib><creatorcontrib>Martínez-Martínez, Juan Gabriel</creatorcontrib><creatorcontrib>Rivera-Caravaca, José Miguel</creatorcontrib><creatorcontrib>Marín, Francisco</creatorcontrib><title>Clinical implications of diabetes mellitus in patients with acute coronary syndrome: Prognostic role and use of new P2Y 12 receptor inhibitors</title><title>Diabetes research and clinical practice</title><addtitle>Diabetes Res Clin Pract</addtitle><description>We investigated the impact of diabetes mellitus (DM) in acute coronary syndrome (ACS) patients, and the 2-year prognosis based on antiplatelet therapy.
This is a prospective and multicenter registry including hospitalized ACS patients. Clinical management and antiplatelet therapy at discharge were recorded. Bleeding events, all-cause mortality and major adverse cardiovascular events (MACEs) were recorded during 2-years and compared according to DM and the P2Y
receptor inhibitor.
From 1717 ACS patients, 653 (38%) had DM. Diabetic patients were older, more commonly females, with higher prevalence of comorbidities and more conservative management. After excluding antiplatelet monotherapy or oral anticoagulation, clopidogrel was prescribed in 59.6% of DM patients. Cox regression analysis showed that DM was an independent risk factor for MACE (aHR 1.39, 95% CI 1.05-1.83). The use of clopidogrel instead of ticagrelor/prasugrel was also independently associated with MACE (aHR 1.71, 95% CI 1.11-2.63), and all-cause mortality (aHR 2.47, 95% CI 1.23-4.96) in diabetic patients (log-rank p-values < 0.001).
In ACS patients, DM was associated with higher risk of MACE. In such patients, the use of ticagrelor/prasugrel reduced MACE and mortality compared to clopidogrel. Novel P2Y
receptor inhibitors might be used as the first therapeutic choice in these high-risk patients.</description><subject>Acute Coronary Syndrome - drug therapy</subject><subject>Diabetes Mellitus - chemically induced</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Percutaneous Coronary Intervention</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Purinergic P2Y Receptor Antagonists - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1872-8227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFj8tOAzEMRSMk1JbHJ4D8Ax2STOcB2wrEsotuWFWZGbd1lccozqjqT_DNpBKsWd0j2zrWFeJJyUJJVb-cioFMF5ELLbXOs1etqhuxUG2jl63WzVzcMZ-klHW5qmZiXlayrepVsxDfa0ueemOB3GgzJAqeIezhqsSEDA6tpTQxkIcx79EnhjOlI5h-Sgh9iMGbeAG--CEGh2-wieHgAyfqIQaLYPwAE-NV6_EMG_0FSkPEHscUYhYfqaNM_CBu98YyPv7mvXj-eN-uP5fj1DkcdmMkl1_t_gqU_x78AC_zWus</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Gil-Perez, Pablo</creator><creator>Ruiz-Nodar, Juan Miguel</creator><creator>Esteve-Pastor, María Asunción</creator><creator>Hortelano, Ignacio</creator><creator>Villamía, Beatriz</creator><creator>Vicente-Ibarra, Nuria</creator><creator>Orenes-Piñero, Esteban</creator><creator>Macías, Manuel Jesús</creator><creator>Núñez-Martínez, Laura</creator><creator>Carrillo, Luna</creator><creator>Candela, Elena</creator><creator>Véliz-Martínez, Andrea</creator><creator>López-García, Cecilia</creator><creator>Martínez-Martínez, Juan Gabriel</creator><creator>Rivera-Caravaca, José Miguel</creator><creator>Marín, Francisco</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>202202</creationdate><title>Clinical implications of diabetes mellitus in patients with acute coronary syndrome: Prognostic role and use of new P2Y 12 receptor inhibitors</title><author>Gil-Perez, Pablo ; 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This is a prospective and multicenter registry including hospitalized ACS patients. Clinical management and antiplatelet therapy at discharge were recorded. Bleeding events, all-cause mortality and major adverse cardiovascular events (MACEs) were recorded during 2-years and compared according to DM and the P2Y
receptor inhibitor.
From 1717 ACS patients, 653 (38%) had DM. Diabetic patients were older, more commonly females, with higher prevalence of comorbidities and more conservative management. After excluding antiplatelet monotherapy or oral anticoagulation, clopidogrel was prescribed in 59.6% of DM patients. Cox regression analysis showed that DM was an independent risk factor for MACE (aHR 1.39, 95% CI 1.05-1.83). The use of clopidogrel instead of ticagrelor/prasugrel was also independently associated with MACE (aHR 1.71, 95% CI 1.11-2.63), and all-cause mortality (aHR 2.47, 95% CI 1.23-4.96) in diabetic patients (log-rank p-values < 0.001).
In ACS patients, DM was associated with higher risk of MACE. In such patients, the use of ticagrelor/prasugrel reduced MACE and mortality compared to clopidogrel. Novel P2Y
receptor inhibitors might be used as the first therapeutic choice in these high-risk patients.</abstract><cop>Ireland</cop><pmid>35085647</pmid><doi>10.1016/j.diabres.2022.109215</doi></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute Coronary Syndrome - drug therapy Diabetes Mellitus - chemically induced Diabetes Mellitus - drug therapy Female Humans Percutaneous Coronary Intervention Platelet Aggregation Inhibitors - therapeutic use Prognosis Prospective Studies Purinergic P2Y Receptor Antagonists - therapeutic use Treatment Outcome |
| title | Clinical implications of diabetes mellitus in patients with acute coronary syndrome: Prognostic role and use of new P2Y 12 receptor inhibitors |
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