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Prediction of major adverse cardiac, cerebrovascular events in patients with diabetes after acute coronary syndrome

Posted on 2019-12-17 - 13:07
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.

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Diabetes and Vascular Disease Research

AUTHORS (14)

Aurora Baluja
Moisés Rodríguez-Mañero
Alberto Cordero
Bahij Kreidieh
Diego Iglesias-Alvarez
Jose M García-Acuña
Alvaro Martínez-Gómez
Rosa Agra-Bermejo
Leyre Alvarez-Rodríguez
Charigan Abou-Jokh
Mónica López-Ratón
Francisco Gude-Sampedro
Julián Alvarez-Escudero
Jose R González-Juanatey
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