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Prevalence and clin...
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Giraldez, Roberto R.
(author)
Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome
- Article/chapterEnglish2013
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Elsevier BV,2013
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LIBRIS-ID:oai:DiVA.org:uu-202892
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-202892URI
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https://doi.org/10.1016/j.ahj.2013.01.005DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background We examined the prevalence of undiagnosed diabetes or prediabetes and associations with ischemic outcomes among non-ST-segment elevation acute coronary syndrome (ACS) patients. Methods We categorized 8795 EARLY ACS trial patients into one of the following groups: "known diabetes" (n = 2860 [32.5%]; reported on the case report form), "undiagnosed diabetes" (n = 1069 [12.2%]; no diabetes history and fasting glucose >= 126 mg/dL or hemoglobin A(1c) >= 6.5%), "prediabetes" (n = 947 [10.8%]; fasting glucose >= 110 to <126 mg/dL, or " normal" (n = 3919 [44.5%]). Adjusted associations of known diabetes, undiagnosed diabetes, and prediabetes (versus normal) with 30-day and 1-year outcomes were determined. Results Undiagnosed diabetes was associated with greater 30-day death or myocardial infarction (MI) (ORadj 1.28, 95% CI 1.05-1.57), driven primarily by greater 30-day mortality (ORadj 1.65, 95% CI 1.09-2.48). Known diabetic patients had 30-day death or MI outcomes similar to those of normal patients, but 30-day mortality was higher (ORadj 1.40, 95% CI 1.01-1.93). Prediabetic patients had 30-day death or MI outcomes similar to those of normal patients. One-year mortality was greater among known diabetic patients (HRadj 1.38, 95% CI 1.13-1.67) but not among those with undiagnosed diabetes or prediabetes. Conclusions Undiagnosed diabetes and prediabetes were common among high-risk non-ST-segment elevation ACS patients. Routine screening for undiagnosed diabetes may be useful since these patients seem to have worse short-term outcomes and deserve consideration of alternative management strategies.
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Clare, Robert M.
(author)
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Lopes, Renato D.
(author)
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Dalby, Anthony J.
(author)
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Prabhakaran, Dorairaj
(author)
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Brogan, Gerard X., Jr.
(author)
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Giugliano, Robert P.
(author)
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James, Stefan K.Uppsala universitet,Kardiologi(Swepub:uu)stjam367
(author)
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Tanguay, Jean-Francois
(author)
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Pollack, Charles V., Jr.
(author)
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Harrington, Robert A.
(author)
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Braunwald, Eugene
(author)
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Newby, L. Kristin
(author)
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Uppsala universitetKardiologi
(creator_code:org_t)
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In:American Heart Journal: Elsevier BV165:6, s. 918-925.e20002-87031097-6744
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