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Should PRECISE-DAPT be included for long-term prognostic stratification of diabetic patients with NSTEACS?

Authors :
García-Rodeja Arias F
Álvarez Álvarez B
González Ferrero T
Martinón Martínez J
Otero García Ó
Tasende Rey P
Cacho Antonio CE
Abou Jokh Casas C
Zuazola P
Jiménez Ramos V
Cordero A
Escribano D
Cid Álvarez B
Iglesias Álvarez D
Agra Bermejo RM
Rigueiro Veloso P
García Acuña JM
Gude Sampedro F
González Juanatey JR
Source :
Acta diabetologica [Acta Diabetol] 2022 Feb; Vol. 59 (2), pp. 163-170. Date of Electronic Publication: 2021 Sep 13.
Publication Year :
2022

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.<br />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.<br />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.<br /> (© 2021. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Details

Language :
English
ISSN :
1432-5233
Volume :
59
Issue :
2
Database :
MEDLINE
Journal :
Acta diabetologica
Publication Type :
Academic Journal
Accession number :
34515850
Full Text :
https://doi.org/10.1007/s00592-021-01792-w