Prediction of major adverse cardiac, cerebrovascular events in patients with diabetes after acute coronary syndrome
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Diabetes & Vascular Disease Research
Type of content
DeCSpronóstico | incidencia | factores de riesgo | pruebas de valores predictivos | estudios retrospectivos | mediana edad | trastornos cerebrovasculares | síndrome coronario agudo | anciano | humanos | evaluación de riesgos | factores de tiempo | enfermedades cardíacas | diabetes mellitus
MeSHRisk Factors | Heart Diseases | Middle Aged | Acute Coronary Syndrome | Cerebrovascular Disorders | Incidence | Predictive Value of Tests | Risk Assessment | Humans | Time Factors | Diabetes Mellitus | Aged | Retrospective Studies | Prognosis
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.