title: Diabetes Mellitus, Hypertension and Hypercholesterolemia in Relation to the 10-Year ACS Prognosis; the GREECS Study.
abstract: Although hypertension, hypercholesterolemia and diabetes mellitus (DM) are recognized as major cardio-metabolic risk factors in primary Acute Coronary Syndrome (ACS) prevention, studies focusing on secondary ACS incidence are scarce. In the present study, the association between the aforementioned factors and 10-year ACS prognosis was evaluated. From October 2003 to September 2004 2,172 consecutive patients with ACS diagnosis, from 6 Greek hospitals, were enrolled. During 2013-14, the 10-year follow-up was performed in 1,918 participants. Baseline clinical factors were assessed through physical examination, medical records and pharmacological management. All-cause mortality and the development of fatal or non-fatal ACS events were recorded through medical records or hospital registries. Logistic regression models were applied to evaluate the impact of baseline clinical status on the ACS prognosis. The 10-year all cause and ACS mortality rate was 32.6 and 17.8%, respectively. Multi-adjusted analysis highlighted that, after taking into account various potential confounders, DM was the sole clinical factor associated with adverse effect on the 10-year ACS fatal incidence [Odds Ratio (OR)=1.35, 95% Confidence Interval (95% CI) 1.01, 1.80, p=0.04]. DM was the only clinical factor that aggravated ACS prognosis, whereas abnormal lipids profile and blood pressure did not seem to determine prognosis. Thus, glycaemic control may play a critical role in the secondary CVD prevention management of ACS patients.
authors.forename: Venetia
authors.initials: V
authors.lastname: Notara
authors.affiliation: 46 Paleon Polemiston St. 166 74, Glyfada, Greece. d.b.panagiotakos@usa.net.
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Moscho
authors.initials: M
authors.lastname: Michalopoulou
authors.forename: Matina
authors.initials: M
authors.lastname: Kouvari
authors.forename: Eleni
authors.initials: E
authors.lastname: Tsompanaki
authors.forename: Margarita
authors.initials: M
authors.lastname: Verdi
authors.forename: Nikos
authors.initials: N
authors.lastname: Vassileiou
authors.forename: Eleni
authors.initials: E
authors.lastname: Kalli
authors.forename: Yannis
authors.initials: Y
authors.lastname: Mantas
authors.forename: Yannis
authors.initials: Y
authors.lastname: Kogias
authors.forename: Petros
authors.initials: P
authors.lastname: Stravopodis
authors.forename: George
authors.initials: G
authors.lastname: Papanagnou
authors.forename: Spyros
authors.initials: S
authors.lastname: Zombolos
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000473:pathology; D000368:Aged; D001786:Blood Glucose / Q000502:physiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology* / Q000209:etiology*; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology*; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012307:Risk Factors
chemical_list: D001786:Blood Glucose