Newly detected diabetes mellitus patients with acute coronary syndrome have an adverse cardiometabolic profile similar to patients with prior diabetes and a more extensive ischemic myocardial insult

Loukianos S Rallidis; Konstantinos A Papathanasiou; Donatos Tsamoulis; Vasileios Bouratzis; Ioannis Leventis; Charalampos Kalantzis; Belkis Malkots; Petros Kalogeras; Dimitrios Tasoulas; Iosif Delakis; Apostolos Lykoudis; Stylianos Daios; Victoria Potoupni; Stelios Zervakis; Athinagoras Theofilatos; Georgios Kotrotsios; Peggy M Kostakou; Konstantinos Kostopoulos; Pantelis Gounopoulos; Virginia Mplani; Evangelos Zacharis; Nikolaos Barmpatzas; Athanasios Kotsakis; Christodoulos Papadopoulos; Athanasios Trikas; Antonios Ziakas; Ioannis Skoularigis; Katerina K Naka; Dimitrios Tziakas; Demosthenes Panagiotakos; Charalambos Vlachopoulos

doi:10.1016/j.diabres.2024.111664

Newly detected diabetes mellitus patients with acute coronary syndrome have an adverse cardiometabolic profile similar to patients with prior diabetes and a more extensive ischemic myocardial insult

Diabetes Res Clin Pract. 2024 Apr 9:211:111664. doi: 10.1016/j.diabres.2024.111664. Online ahead of print.

Authors

Loukianos S Rallidis¹, Konstantinos A Papathanasiou², Donatos Tsamoulis³, Vasileios Bouratzis⁴, Ioannis Leventis⁵, Charalampos Kalantzis⁶, Belkis Malkots⁷, Petros Kalogeras⁴, Dimitrios Tasoulas⁸, Iosif Delakis⁹, Apostolos Lykoudis¹⁰, Stylianos Daios¹¹, Victoria Potoupni¹², Stelios Zervakis¹³, Athinagoras Theofilatos¹⁴, Georgios Kotrotsios¹, Peggy M Kostakou¹⁵, Konstantinos Kostopoulos⁹, Pantelis Gounopoulos¹⁰, Virginia Mplani¹⁴, Evangelos Zacharis¹³, Nikolaos Barmpatzas⁹, Athanasios Kotsakis⁸, Christodoulos Papadopoulos¹², Athanasios Trikas¹⁶, Antonios Ziakas¹¹, Ioannis Skoularigis⁵, Katerina K Naka⁴, Dimitrios Tziakas⁷, Demosthenes Panagiotakos¹⁷, Charalambos Vlachopoulos⁶

Affiliations

¹ 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece.
² 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece. Electronic address: kpapathanasiou91@gmail.com.
³ Cardiology Department, Thriasio General Hospital, Elefsina, Greece.
⁴ Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
⁵ Department of Cardiology, University General Hospital of Larissa, Larissa, Greece.
⁶ 1st Department of Cardiology, Medical School, National and Kapodistrian, University of Athens, Hippokration Hospital, Athens, Greece.
⁷ Cardiology Department, Medical School, Democritus University of Thrace, Dragana, Alexandroupolis, Greece.
⁸ 2nd Department of Cardiology, General Hospital of Nikea, Piraeus, Greece.
⁹ 1st Department of Cardiology, General Hospital of Nikea, Piraeus, Greece.
¹⁰ 2nd Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece.
¹¹ 1st Department of Cardiology, University General Hospital of Thessaloniki, AHEPA, Thessaloniki, Greece.
¹² 3rd Cardiology Department, Hippokration University Hospital, Aristotle University, Thessaloniki, Greece.
¹³ Cardiology Department, Heraklion University Hospital, Crete, Greece.
¹⁴ Department of Cardiology, Patras University Hospital, Patras, Greece.
¹⁵ Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece.
¹⁶ Cardiology Department, Elpis General Hospital, Athens, Greece.
¹⁷ School of Health Sciences and Education, Harokopio University, Athens, Greece.

PMID: 38604446
DOI: 10.1016/j.diabres.2024.111664

Abstract

Aims: The impact of newly detected diabetes mellitus (NDDM) on metabolic parameters and extent of myocardial necrosis in patients with acute coronary syndrome (ACS) is not fully explored. We examined the impact of NDDM on cardiometabolic characteristics and myocardial necrosis in ACS patients.

Methods: CALLINICUS-Hellas Registry is an ongoing prospective multicenter observational study evaluating the adherence to lipid-lowering therapy (LLT) among ACS patients in Greece. Three groups were created: a) patients with NDDM (abnormal fasting glucose, HbA1c ≥ 6.5 % and no previous history of DM), b) patients without known DM and HbA1c < 6.5 % (non-DM) and c) patients with prior DM.

Results: The prevalence of NDDM among 1084 patients was 6.9 %. NDDM patients had lower HDL-C [38 (32-45) vs 42 (36-50) mg/dL] and higher triglycerides levels [144 (104-231) vs 115 (87-152) mg/dL] compared to non-DM patients (p < 0.05). NDDM patients featured both higher body mass index [29.5 (26.4-34.3) vs 27.1 (24.9-29.9) kg/m²] and waist circumference [107 (100-114) vs 98 (91-106) cm] compared to non-DM patients (p < 0.05). In addition, NDDM patients had more extensive myocardial necrosis than patients with prior DM.

Conclusions: ACS patients with NDDM have an adverse cardiometabolic profile similar to patients with prior DM and have more extensive myocardial insult.

Keywords: Acute coronary syndrome; Body mass index; Multivessel coronary artery disease; Myocardial insult; Newly detected diabetes mellitus; Waist circumference.