• Miquel Gual, Francesc Formiga, Albert Ariza-Solé, Ramon López-Palop, Juan Sanchís, Francisco Marín, María T Vidán, Manuel Martínez-Sellés, Alessandro Sionis, José C Sánchez-Salado, Victòria Lorente, Pablo Díez-Villanueva, Miquel Vives-Borrás, Alberto Cordero, Héctor Bueno, Oriol Alegre, Emad Abu-Assi, Àngel Cequier, and LONGEVO-SCA registry investigators.
• Cardiology Department, Bellvitge University Hospital, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
• Aging Clin Exp Res. 2019 Nov 1; 31 (11): 1635-1643.

BackgroundThe magnitude of the association between diabetes (DM) and outcomes in elderly patients with acute coronary syndromes (ACS) is controversial. No study assessed the prognostic impact of DM according to frailty status in these patients.MethodsThe LONGEVO-SCA registry included unselected ACS patients aged ≥ 80 years. Frailty was assessed by the FRAIL scale. We evaluated the impact of previous known DM on the incidence of death or readmission at 6 months according to status frailty by the Cox regression method.ResultsA total of 532 patients were included. Mean age was 84.3 years, and 212 patients (39.8%) had previous DM diagnosis. Patients with DM had more comorbidities and higher prevalence of frailty (33% vs 21.9%, p = 0.002). The incidence of death or readmission at 6 months was higher in patients with DM (HR 1.52, 95% CI 1.12-2.05, p 0.007), but after adjusting for potential confounders this association was not significant. The association between DM and outcomes was not significant in robust patients, but it was especially significant in patients with frailty [HR 1.72 (1.05-2.81), p = 0.030, p value for interaction = 0.049].ConclusionsAbout 40% of elderly patients with ACS had previous known DM diagnosis. The association between DM and outcomes was different according to frailty status.

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