Abstract 5608: Recognition of Abnormal Glucose Metabolism and Its Impact on Treatment in Patients With Acute Myocardial Infarction in Germany: Results of the SWEETHEART Registry

Abstract

Background: Recent reports from epidemiological studies demonstrated a high prevalence of undiagnosed diabetes in patients with coronary artery disease. These findings led to joint guidelines by the ESC and the EASD on diabetes, pre-diabetes and cardiovascular disease. Methods: Since 2007, 1,773 consecutive patients with STEMI or NSTEMI were enrolled into the MI-registry SWEETHEART to document patients’ characteristics and treatment in clinical practice with special emphasis on the identification of abnormal glucose metabolism. In patients with previously unknown diabetes, oral glucose tolerance test was performed at day 4 after the acute MI. We examined the prevalence of abnormal glucose metabolism and its impact on treatment in clinical practice. Results: Out of 1,773 consecutive patients with MI, 919 (52.3%) presented with STEMI and 837 (47.7%) with NSTEMI. Diabetes was already known in 33.0% of patients. Oral glucose tolerance tests identified another 16.1% of patients with manifest diabetes and 22.4% with impaired fasting glucose or impaired glucose tolerance (pre-diabetes). Only 28.5% of the MI population had no signs of abnormal glucose tolerance. Medical treatment for secondary prevention at discharge was quite well according to guidelines for antiplatelet therapy, betablockers, statins, ACE-inhibitors and ARB for all patients. Nevertheless, only 61.1% of patients with newly diagnosed diabetes did receive treatment for diabetes at discharge, in whom 74.0% only received diet. Conclusion: There was a high prevalence of newly diagnosed diabetes and pre-diabetes in consecutive patients with myocardial infarction in Germany. Despite new guidelines by the ESC and the EASD with clear recommendations for early and aggressive therapy of diabetes in patients with cardiovascular disease, 40% of myocardial infarction patients with newly diagnosed diabetes did not receive diet or an antidiabetic treatment at discharge.