Controle glicêmico intensivo em pacientes com Infarto agudo do miocárdio: tempo de duração do Diabetes conta

A doenca cardiaca coronariana e a principal causa de morte em pacientes diabeticos. A presenca do diabetes mellitus tipo II (DMTII) poe os pacientes com e sem historia previa de infarto do miocardio em risco cardiovascular significativo. Objetivo: Avaliar o impacto prognostico do tempo de duracao e controle metabolico do DMTII em uma populacao hospitalizada por sindrome coronariana aguda. Metodos: Estudo retrospectivo realizado com 731 pacientes consecutivos admitidos por sindrome coronariana aguda no periodo de maio de 2007 a agosto de 2013. Os pacientes foram estratificados em: Grupo 1 (n=297), com diabetes mellitus (DM) conhecido (previamente a hospitalizacao) e hemoglobina A1c (HbA1c) Cardiovascular disease (CVD) is the leading cause of death in patients with diabetes. The presence of type 2 diabetes mellitus (T2DM) puts the patients with and without history of myocardial infarction at risk for significant cardiovascular risk.OBJECTIVE: To evaluate the prognostic impact of the time of duration and metabolic control of T2DM in a population hospitalized for acute coronary syndrome.METHODS: Retrospective study of 731 consecutive patients admitted for acute coronary syndrome from May 2007 to August 2013. Patients were stratified into: Group 1 (n=297) with known diabetes mellitus (DM) (prior to hospitalization) and hemoglobin A1c (HbA1c) 6.5%; Group 3 (n=39), with recently diagnosed DM (during hospitalization) and HbA1c 6.5%. The primary endpoint was death from all causes (cardiovascular and non-cardiovascular) at one year, and the secondary endpoint at two years of follow-up.RESULTS: The distribution by sex and age was similar in both groups. In-hospital mortality was also higher in Group 2 (4.4%). Mortality from all causes over one year was higher in Groups 1 (8.3%) and 4 (8.3%), and at two years was higher in Group 1 (9.8%). Group 3 had better prognosis.CONCLUSION: Of the data presented, the authors consider that the diabetes time of duration is important to decide the therapy and adjust the target of metabolic control of patients with ACS.(AU)