Frequency and structure of adverse annual outcomes in patients with acute coronary syndrome without ST-segment elevation, depending on presence of type 2 diabetes mellitus
Aim: to assess the frequency and structure of adverse outcomes in patients with acute coronary syndrome without ST segment elevation, depending on the presence of type 2 diabetes at follow-up of one year. Materials and methods: 153 patients with acute coronary syndrome without ST segment elevation were included in the prospective study from March 2014 to January 2017. All patients were divided into two groups: group 1 - with the presence of type 2 diabetes (n = 44 (28.7 %)), the annual follow-up was evaluated in 40 (90.9 %) patients. The second group included 109 (71.2 %) patients without type 2 diabetes, the annual follow-up was evaluated in 99 (90.8 %) patients. Adverse outcomes during one year follow-up such as cardiovascular mortality, nonfatal myocardial infarction, nonfatal acute cerebrovascular accident, hospitalization for unstable angina, decompensation of chronic heart failure, as well as a combined endpoint, including all listed adverse outcomes have been evaluated in both patient groups. Results: there were no significant differences between the groups according to clinical and anamnestic characteristics at enrollment in the study. In the group of patients with type 2 diabetes, 5 (13.5 %) died for cardiovascular reason against 15 (15.8 %) patients in the group without diabetes, recurrent MI developed in 2 (5.9 %) of patients with type 2 diabetes and 7 (7.8 %) patients without diabetes, 3 (9.4 %) patients with type 2 diabetes and 4 (4.9 %) patients without diabetes were at least once hospitalized with HF decomposition. Non fatal acute stroke was revealed significantly more often (p = 0,008) in the patients group with type 2 diabetes-8 (21,6 %) against 5 (5,7 %) patients without type 2 diabetes (p = 0,008). The incidence of combined endpoint development was non-significantly higher (p = 0.12) in the group of patients with type 2 diabetes compared with that in patients without impaired carbohydrate metabolism. Conclusion: in type 2 diabetes patients after acute coronary syndrome without ST segment elevation nonfatal acute cerebrovascular accident developed in 20,0 % of cases which is significantly (p = 0,008) more often than in similar patients without diabetes (5,1 %). at one year of follow-up.