Gerbaud E, et al. - In patients with diabetes and acute coronary syndrome (ACS), researchers analyzed the association between glycemic variability (GV) and the occurrence of midterm major cardiovascular events (MACE) as well as studied the prognostic value of GV. The highest independent predictive factor for mid-term MACE in patients with diabetes and ACS was a GV cutoff value of >2.70 mmol/L.

Methods

• Between January 2015 and November 2016, consecutive patients with diabetes and ACS were included.
• During initial hospitalization, GV was evaluated using SD.
• MACE has been recorded, including new-onset myocardial infarction, acute heart failure and cardiac death.
• In terms of baseline characteristics and cardiac status, the predictive effects of GV on patient outcomes were analyzed.

Results

• A total of 327 patients were enrolled with diabetes and ACS.
• During a mean follow-up of 16.9 months, MACE occurred in 89 patients (27.2%).
• Twenty-four patients (7.3%) died of cardiac causes, 35 (10.7%) had new-onset myocardial infarction, and 30 (9.2%) were hospitalized for acute heart failure during follow-up.
• Multivariable logistic regression analysis demonstrated that GV >2.70 mmol/L, a Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score of >34, and reduced left ventricular ejection fraction of <40% were independent predictors of MACE, with odds ratios (ORs) of 2.21 (95% CI 1.64–2.98; P < 0.001), 1.88 (1.26–2.82; P=0.002), and 1.71 (1.14–2.54; P=0.009), respectively.
• On the other hand, a Global Registry of Acute Coronary Events risk score >140 was not (OR 1.07 [0.77–1.49]; P=0.69).