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Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome
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2013 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 165, no 6, 918-925.e2 p.Article in journal (Refereed) Published
Abstract [en]

Background We examined the prevalence of undiagnosed diabetes or prediabetes and associations with ischemic outcomes among non-ST-segment elevation acute coronary syndrome (ACS) patients. Methods We categorized 8795 EARLY ACS trial patients into one of the following groups: "known diabetes" (n = 2860 [32.5%]; reported on the case report form), "undiagnosed diabetes" (n = 1069 [12.2%]; no diabetes history and fasting glucose >= 126 mg/dL or hemoglobin A(1c) >= 6.5%), "prediabetes" (n = 947 [10.8%]; fasting glucose >= 110 to <126 mg/dL, or " normal" (n = 3919 [44.5%]). Adjusted associations of known diabetes, undiagnosed diabetes, and prediabetes (versus normal) with 30-day and 1-year outcomes were determined. Results Undiagnosed diabetes was associated with greater 30-day death or myocardial infarction (MI) (ORadj 1.28, 95% CI 1.05-1.57), driven primarily by greater 30-day mortality (ORadj 1.65, 95% CI 1.09-2.48). Known diabetic patients had 30-day death or MI outcomes similar to those of normal patients, but 30-day mortality was higher (ORadj 1.40, 95% CI 1.01-1.93). Prediabetic patients had 30-day death or MI outcomes similar to those of normal patients. One-year mortality was greater among known diabetic patients (HRadj 1.38, 95% CI 1.13-1.67) but not among those with undiagnosed diabetes or prediabetes. Conclusions Undiagnosed diabetes and prediabetes were common among high-risk non-ST-segment elevation ACS patients. Routine screening for undiagnosed diabetes may be useful since these patients seem to have worse short-term outcomes and deserve consideration of alternative management strategies.

Place, publisher, year, edition, pages
2013. Vol. 165, no 6, 918-925.e2 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-202892DOI: 10.1016/j.ahj.2013.01.005ISI: 000319439900013OAI: oai:DiVA.org:uu-202892DiVA: diva2:634666
Available from: 2013-07-01 Created: 2013-07-01 Last updated: 2013-07-01Bibliographically approved

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