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oai:docta.ucm.es:20.500.14352/47962024-10-09T17:16:31Zcom_20.500.14352_14col_20.500.14352_15

Prognosis Impact of Diabetes in Elderly Women and Men with Non-ST Elevation Acute Coronary Syndrome Díez Villanueva, Pablo García Acuña, Jose María Raposeiras Roubin, Sergio Barrabés, Jose A. Cordero, Alberto Bardají, Alfredo Martínez-Sellés D Oliveira Soares, Manuel Marín, Francisco Ruiz Nodar, Juan M. Vicente Ibarra, Nuria Alonso Salinas, Gonzalo L. Cid Alvárez, Belén Abu Assi, Emad Formiga, Frances Núñez, Julio Núñez, Eduardo Ariza Solé, Albert Sanchis, Juan elderly non-ST-segment elevation acute coronary syndromes women diabetes mellitus Dietética y nutrición (Medicina) Endocrinología 3206 Ciencias de la Nutrición 3205.02 Endocrinología Few studies have addressed to date the interaction between sex and diabetes mellitus (DM) in the prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Our aim was to address the role of DM in the prognosis of non-selected elderly patients with NSTEACS according to sex. A retrospective analysis from 11 Spanish NSTEACS registries was conducted, including patients aged ≥70 years. The primary end point was one-year all-cause mortality. A total of 7211 patients were included, 2,770 (38.4%) were women, and 39.9% had DM. Compared with the men, the women were older (79.95 ± 5.75 vs. 78.45 ± 5.43 years, p < 0.001) and more often had a history of hypertension (77% vs. 83.1%, p < 0.01). Anemia and chronic kidney disease were both more common in women. On the other hand, they less frequently had a prior history of arteriosclerotic cardiovascular disease or comorbidities such as peripheral artery disease and chronic pulmonary disease. Women showed a worse clinical profile on admission, though an invasive approach and in-hospital revascularization were both more often performed in men (p < 0.001). At a one-year follow-up, 1090 patients (15%) had died, without a difference between sexes. Male sex was an independent predictor of mortality (HR = 1.15, 95% CI 1.01 to 1.32, p = 0.035), and there was a significant interaction between sex and DM (p = 0.002). DM was strongly associated with mortality in women (HR: 1.45, 95% CI = 1.18–1.78; p < 0.001), but not in men (HR: 0.98, 95% CI = 0.84–1.14; p = 0.787). In conclusion, DM is associated with mortality in older women with NSTEACS, but not in men. Instituto de Salud Carlos III (ISCIII)/MINECO Depto. de Medicina Fac. de Medicina TRUE pub 2023-06-16T14:21:20Z 2023-06-16T14:21:20Z 2021-09-26 journal article https://hdl.handle.net/20.500.14352/4796 2077-0383 10.3390/jcm10194403 eng CIBER-CV 16/11/00420 Atribución 3.0 España https://creativecommons.org/licenses/by/3.0/es/ open access application/pdf MPDI