Savonitto et al identified predictors for mortality of a patient with type 2 diabetes mellitus who has survived an acute coronary syndrome. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Europe, Australia, Canada, and the United States
Patient selection: type 2 diabetes mellitus, status post acute coronary syndrome (ACS)
Median follow-up: 2 years
Outcomes:
(1) all-cause mortality
(2) cardiovascular mortality
Parameter
HR for All Cause Mortality
HR for Cardiovascular Mortality
serum NT-proBNP
1.7
1.8
coronary revascularization
2.3
2.5
age
1.04 per year increase
1.03 per year increase
heart rate in bpm
1.02 per beat increase
1.02 per beat increase
hemoglobin A1c in percent
1.11 per 1% increase
1.12 per 1% increase
hemoglobin in g/L
1.01 per g/L decrease
1.01 per 1 g/L decrease
prior coronary bypass surgery (not current hospitalization)
1.6
1.8
prior myocardial infarction
1.4
1.5
Other factors from univariate analysis:
(1) chronic kidney disease
(2) diabetic retinopathy
(3) need for insulin
(4) peripheral vascular disease
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