Clinical Outcomes and Cardiovascular-Related Events in Young Diabetic Patients with Acute Coronary Syndrome

Abstract

Background: Diabetes mellitus (DM) is considered a risk and prognostic factor for elderly patients with the acute coronary syndrome (ACS). However, less is known about the characteristics of this relationship among younger patients in the Middle Eastern population. Objective: To explore the Clinical outcomes of cardiovascular-related events in young DM patients (≤50 years of age) during hospitalization and up to one year of follow-up. Methods: We compared the clinical features, in-hospital and one-year outcomes in young ACS diabetic patients with young ACS non-diabetic patients in 12 tertiary care centers in Jordan. Results: A total of 3517 ACS patients were included initially, 1031 of whom (29.3%) were <50-year-old. Of those, 385 (37.3%) had DM. Compared with young non-diabetic patients, young diabetic patients were more likely to have a worse clinical baseline profile, which includes hypertension (53.2% vs 26.0%, p < 0.001), dyslipidemia (32.5% vs 19.5%, p < 0.001), and multivessel coronary artery disease (40.9% vs 32.0%, p = 0.03). Furthermore, the diabetic group had more females than males (14.0% vs 5.9%, p < 0.001) and a higher mean body mass index (28.8+4.7 kg/m 2 vs 27.9+4.0 kg/m2, p < 0.001). There were no differences between the two groups in the mortality rates during index hospitalization (0.39% vs 0.28%, p = 0.63) or at one-year follow-up (1.6% vs 0.6%, p = 0.41). Also, no significant differences were observed in the rates of stent thrombosis (1.95% vs 1.97%, p = 0.78) or readmission for ACS or coronary revascularization (10.8% vs 7.6%, p = 0.14). Conclusion: Despite a worse baseline clinical profile, young diabetic ACS patients did not have higher risks for in-hospital or one-year adverse cardiovascular events compared with the young non-diabetic ACS patients.