Poster Session 2 – Morning

Abstract

Introduction: Acute Coronary Syndrome(ACS) is the most common cause of admission in a coronary care unit.Contrary to the decline in the prevalence of several risk factors such as hypertension, hypercholesterolemia and smoking, diabetes is an expanding health burden in the Western world. Because of the proatherosclerotic, proinflammatory, and prothrombotic states associated with diabetes, diabetic patients with acute coronary syndromes (ACS) are at high risk of subsequent cardiovascular events. Aim: To see the prevalence and in-hospital outcome of Diabetes Mellitus in patients admitted with ACS. Methods: This study was carried out in Department of cardiovascular medicine, National Institute of Cardiovascular Diseases(NICVD), Dhaka from the period of May 2010 to April 2011. 3800 consecutive hospitalized patients with ACS were included in the study. The criteria for the diagnosis of ACS were based on clinical presentation, biochemical makers of acute ischemic injury, and ECG findings. As per ADA guidelines patients with FBS =126 or PPBS =200 or HbA1C >6.5% was diagnosed as diabetic. Results: A total of 3800 patients were admitted with ACS of which 2926( 77%) were males and 874(23%) were females. Among 3800 ACS patients 1596(42%) were diabetic. Among 1596 diabetic patients 75.19% were male and 24.81% were female. Age wise prevalence of ACS was highest in age group 50-59 yrs and 60-69 yrs in both male and females. 40 % Female patients presented with unstable angina and 60% were diabetic. 65 % male patients had STEMI and 50%of whom were diabetic. The most commonly associated co-morbidities were HTN, PVD, DYSLIPIDEMIA, CKD and in some cases CVA. Co-morbidities were more common in diabetic population. Among 1596 diabetic patients 62 % were hypertensive, 5.6 % had PVD and 90 % had dyslipidemia. They had longer hospital stay and had increased mortality than nondiabetic. The average hospital stay were 7.1± 2.4 days, 7.2 ± 2.4 days and 6.7 ± 2.2 days in nondiabetics and 8.5 ± 3.3 days 8.8 ± 2.7 and 7.9± 2.4 days in diabetic patients with STEMI, NSTEMI and unstable angina respectively. A total of 95 patients died of which 55 were diabetic and 40 were non-diabetic; Comparing mortality among diabetic and non diabetic group it was 8.1% vs 3.9% in STEMI, 8.4% vs 3.1% in NSTEMI and 3.6% vs 1.1% in Unstable angina group. Conclusions: Type 2 diabetes was very common in patients with acute coronary events. Patients with diabetes more likely experience acute MI, male sex predominance in ACS patients with DM and in-hospital mortality showed higher mortality in ACS patients with diabetes.