Abstract 15682: High 3-Year-Mortality Rates in Females With Newly Diagnosed Diabetes After Acute STEMI and NSTEMI in Clinical Practice in Germany: Results of the SWEETHEART Registry
Background: Many patients with coronary artery disease suffer from diabetes or its pre-states. Joint guidelines by the ESC and the EASD recommend testing for diabetes using OGTT in patients with established CAD and without previously known diabetes.
Methods: Since 2007, 2,767 consecutive patients with STEMI or NSTEMI were enrolled into the MI-registry SWEETHEART to identify abnormal glucose metabolism and to document acute treatment and outcome. In patients with previously unknown diabetes, oral glucose tolerance test (OGTT) was performed at day 4 after acute MI. We examined gender differences in the prevalence of abnormal glucose metabolism and the impact of newly diagnosed diabetes on 3-year-mortality of MI.
Results: Female patients with MI were older, less often had prior MI and prior PCI as compared to males. Female patients had a higher rate of known diabetes as well as a longer duration of diabetes at the time of MI. The prevalence of newly diagnosed impaired glucose metabolism was much higher in females than in males. In females, OGTT identified another 19.8% with manifest diabetes and 18.1% with impaired glucose tolerance (IGT) / impaired fasting glucose (IFG) as compared to 15.3% and 23.3% in males respectively. After 3 years of follow up, female patients with newly diagnosed diabetes had a 30.5% mortality similar to that of females with already known diabetes (30.0%).
Conclusion: Although the prevalence of known diabetes was already much higher in females, the rate of newly diagnosed diabetes was significantly increased in females as compared to males. Females with newly diagnosed diabetes had the same 3-year mortality as those high risk patients with MI and already known diabetes.
- © 2011 by American Heart Association, Inc.