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- Title
Should PRECISE-DAPT be included for long-term prognostic stratification of diabetic patients with NSTEACS?
- Authors
García‑Rodeja Arias, Federico; Álvarez Álvarez, Belén; González Ferrero, Teba; Martinón Martínez, Jesús; Otero García, Óscar; Tasende Rey, Pablo; Cacho Antonio, Carla Eugenia; Abou Jokh Casas, Charigan; Zuazola, Pilar; Jiménez Ramos, Víctor; Cordero, Alberto; Escribano, David; Cid Álvarez, Belén; Iglesias Álvarez, Diego; Agra Bermejo, Rosa María; Rigueiro Veloso, Pedro; García Acuña, José María; Gude Sampedro, Francisco; González Juanatey, José Ramón
- Abstract
Aims: There are insufficient data regarding risk scores validation in patients with diabetes mellitus and non-ST elevation acute coronary syndrome (NSTEACS). We performed a diabetes mellitus-specific analysis of cardiovascular outcomes after NSTEACS. We tested the predictive power of the Global Registry of Acute Coronary Events (GRACE) and PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy (PRECISE-DAPT) scores. Methods: This work is a retrospective analysis that included 7,415 consecutive NSTEACS patients from two Spanish Universitarian hospitals between the years 2003 and 2017. The area under the ROC curve among with and without diabetes mellitus patients was calculated, to evaluate the predictive power of both scores. Results: Among the study participants, 2124 patients (28.0%) were diabetic. The median follow-up was 54,3 months (IQR 24,7–80,0 months). Diabetic patients were more women (30.5% vs. 25.7%) and older (70.0 ± 10.8 vs. 65.3 ± 13.2 years old); they had higher GRACE (146 ± 36 vs. 137 ± 36), PRECISE-DAPT (15 ± 7 vs. 18 ± 9) at admission. Early invasive coronary angiography (≤ 24 h after admission) was performed more frequently in non-diabetic. We tested the predictive power of the GRACE and PRECISE-DAPT risk scores among diabetic and non-diabetic. PRECISE-DAPT risk score showed a good predictive power for all-cause mortality, cardiovascular mortality and MACE in diabetic admitted with NSTEACS, without differences compared to non-diabetic. Conclusions: PRECISE-DAPT risk score has an appropriate predictive power in diabetic patients admitted with NSTEACS compared to non-diabetic NSTEACS. However, GRACE would be predictive worse in diabetic during long-term follow-up in a large contemporary registry.
- Subjects
PEOPLE with diabetes; DISEASE risk factors; ACUTE coronary syndrome; SURGICAL stents; CORONARY angiography; DIABETES
- Publication
Acta Diabetologica, 2022, Vol 59, Issue 2, p163
- ISSN
0940-5429
- Publication type
Article
- DOI
10.1007/s00592-021-01792-w