Endocrine Abstracts

Rationale: Secondary prevention of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) has shown benefit but the level of control is still disappointing. Most of the results are documented within clinical trials. There isn’t enough information in routine clinical practice at short-term tracing. The main aim of this study is to collect information about the level of control of major risk factors in non-selected patients.

Methods: Observational and retrospective study. Patients with T2D who had suffered myocardial infarction between January and December 2012 were included. Data provided by clinical history, with special regard to major cardiovascular risk factors were recorded. Optimal control of risk factors was defined by current clinical guidelines. Clinical events and achievement of targets at baseline, 6 months and 1 year after coronary event were recorded.

Results: Data from 48 T2DM patients (47.9% females, mean age: 70.6±8.7 years, and mean diabetes duration: 10.9±9 years) were collected. 79.2% had hypertension and 66.7% had hyperlipidaemia. At baseline, proportion of patients who met target for non-smoking, SBP, LDL-C, and HbA1c was 89.6, 62.2, 40, and 22.2% respectively. The rates of patients with adequate control at 6 and 12 months after discharge were as follows: non-smokers: 93.9 and 97.1% (P=0.01); SBP: 74.4 and 71.4% (P=0.004); LDL-C: 70 and 83.3% (P<0.001), and HbA1c: 41.4 and 35.5% (P=not significant). Although, follow-up HbA1c level was lower than at baseline, no significantly difference was observed (7.9±1.3% vs 7.3±1.2% vs 7.3±2.1%; P=0.06).

Conclusions: Our outcomes from a routine clinical practice are relatively poor and don’t differ much from the trials results. The rate of adequate control for each risk factor was similar at 6 months and at 1-year after coronary event. It reflects that there is an early improvement that is maintained after optimising treatment.