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Prognosis impact of diabetes in elderly women and men with non-st elevation acute coronary syndrome

  • Dades identificatives

    Identificador: imarina:9229328
    Autors:
    Díez-Villanueva PGarcía-Acuña JMRaposeiras-Roubin SBarrabés JACordero AMartínez-Sellés MBardají AMarín FRuiz-Nodar JMVicente-Ibarra NAlonso Salinas GLCid-Alvárez BAssi EAFormiga FNúñez JNúñez EAriza-Solé ASanchis J
    Resum:
    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.
  • Altres:

    Autor segons l'article: Díez-Villanueva P; García-Acuña JM; Raposeiras-Roubin S; Barrabés JA; Cordero A; Martínez-Sellés M; Bardají A; Marín F; Ruiz-Nodar JM; Vicente-Ibarra N; Alonso Salinas GL; Cid-Alvárez B; Assi EA; Formiga F; Núñez J; Núñez E; Ariza-Solé A; Sanchis J
    Departament: Medicina i Cirurgia
    Autor/s de la URV: Bardají Ruiz, Alfredo
    Paraules clau: Women Sex-related differences Non-st-segment elevation acute coronary syndromes Elderly Diabetes mellitus women trials outcomes non-st-segment elevation acute coronary syndromes myocardial-infarction management long-term mortality heart gender diabetes mellitus age
    Resum: 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.
    Àrees temàtiques: Medicine, general & internal Medicine (miscellaneous) Medicine (all)
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: alfredo.bardaji@urv.cat
    Identificador de l'autor: 0000-0003-1900-6974
    Data d'alta del registre: 2024-07-27
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Enllaç font original: https://www.mdpi.com/2077-0383/10/19/4403
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referència a l'article segons font original: Journal Of Clinical Medicine. 10 (19):
    Referència de l'ítem segons les normes APA: Díez-Villanueva P; García-Acuña JM; Raposeiras-Roubin S; Barrabés JA; Cordero A; Martínez-Sellés M; Bardají A; Marín F; Ruiz-Nodar JM; Vicente-Ibarra (2021). Prognosis impact of diabetes in elderly women and men with non-st elevation acute coronary syndrome. Journal Of Clinical Medicine, 10(19), -. DOI: 10.3390/jcm10194403
    DOI de l'article: 10.3390/jcm10194403
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2021
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Medicine (Miscellaneous),Medicine, General & Internal
    Women
    Sex-related differences
    Non-st-segment elevation acute coronary syndromes
    Elderly
    Diabetes mellitus
    women
    trials
    outcomes
    non-st-segment elevation acute coronary syndromes
    myocardial-infarction
    management
    long-term mortality
    heart
    gender
    diabetes mellitus
    age
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
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