Clinical characteristics, GRACE score, TIMI score and prognosis of patients with type 2 diabetes mellitus complicated with acute coronary syndrome

• 作者: Zhuo-Ya Yao Bing-Wei Bao Shao-Huan Qian Miao-Nan Li Hong-Ju Wang
• 来源期刊: 海南医科大学学报（英文版）
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Original article
• 页码范围: 25-29
• 页数: 5页
• 语种: 英文

摘要

Objective: To analyze the clinical characteristics of patients with type 2 diabetes mellitus (T2DM) with acute coronary syndrome (ACS), the global registry of acute coronary events (GRACE)score,the thrombolysis in myocardial infarction (TIMI) score and clinical prognosis. Method: The study was a retrospective one-center observational study, continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data, laboratory examination results, imaging data and interventional treatment data of all patients. Were divided into: T2DM with ACS group (group DA) and non-T2DM with ACS (group NDA) according to whether or not they were associated with T2DM. According to the GRACE、TIMI score, the two groups were divided into high risk group, middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores. Design questionnaire, after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months, statistics of the occurrence of MACE events. Result: Among the 600 patients included in the study ,362 were male (60.3％) and 238 were female (39.7％) with mean age (64.7±10.3) years. The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group; the proportion of men was lower than in the NDA group. The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group, and the proportion of single lesion was lower than that of NDA group. The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM. GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group, and there was no significant difference between low and middle risk group. TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group, while the proportion of low and middle risk group was lower than that in NDA group. The ROC curve shows that the area (AUC) below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586. Conclusion: Patients with T2DM and ACS had higher clinical risk stratification than without T2DM. GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.