Prediction of major adverse cardiac, cerebrovascular events in patients with diabetes after acute coronary syndrome. (January 2020)

• Record Type: Journal Article
• Authors: Baluja, Aurora; Rodríguez-Mañero, Moisés; Cordero, Alberto; Kreidieh, Bahij; Iglesias-Alvarez, Diego; García-Acuña, Jose M; Martínez-Gómez, Alvaro; Agra-Bermejo, Rosa; Alvarez-Rodríguez, Leyre; Abou-Jokh, Charigan; López-Ratón, Mónica; Gude-Sampedro, Francisco; Alvarez-Escudero, Julián; González-Juanatey, Jose R
• Is Part Of: Diabetes & vascular disease research. Volume 17:Number 1(2020:Jan.)
• Publication Date: 2020-01
• Subjects: Diabetes mellitus -- myocardial infarction -- left ventricle ejection fraction -- cardiovascular death -- major adverse cardiac and cerebrovascular events -- score; Diabetic angiopathies -- Periodicals; 616.462005
• DOI: 10.1177/1479164119892137
• Languages: English
• ISSNs: 1479-1641

Abstract

Background and objectives: The risk of major adverse cardiac and cerebrovascular events following acute coronary syndrome is increased in people with diabetes. Predicting out-of-hospital outcomes upon follow-up remains difficult, and no simple, well-validated tools exist for this population at present. We aim to evaluate several factors in a competing risks model for actionable evaluation of the incidence of major adverse cardiac and cerebrovascular events in diabetic outpatients following acute coronary syndrome. Methods: Retrospective analysis of consecutive patients admitted for acute coronary syndrome in two centres. A Fine–Gray competing risks model was adjusted to predict major adverse cardiac and cerebrovascular events and all-cause mortality. A point-based score is presented that is based on this model. Results: Out of the 1400 patients, there were 783 (55.9%) with at least one major adverse cardiac and cerebrovascular event (417 deaths). Of them, 143 deaths were due to non-major adverse cardiac and cerebrovascular events. Predictive Fine–Gray models show that the 'PG-HACKER' risk factors (gender, age, peripheral arterial disease, left ventricle function, previous congestive heart failure, Killip class and optimal medical therapy) were associated to major adverse cardiac and cerebrovascular events. Conclusion: The PG-HACKER score is a simple and effective tool that is freely available and easily accessible to physicians and patients. The PG-HACKER score can predict major adverse cardiac and cerebrovascular events following acute coronary syndrome in patients with diabetes.