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Ten percent of patients presenting with an acute myocardial infarction had undiagnosed diabetes at the time of their heart attack, underlining the importance of evaluating such patients for diabetes while they are hospitalized, investigators have reported.
The study found that 287 (10.1%) of the 2,854 patients enrolled in a 24-site U.S. acute MI registry, who were not known to have type 2 diabetes on admission, actually had diabetes, reported Dr. Suzanne V. Arnold, a cardiologist at Saint Luke’s Mid America Heart Institute, Kansas City, Mo. The data were presented at the American Heart Association’s Quality of Care and Outcomes Research conference.
The diabetes diagnosis was based on hemoglobin A1c levels of 6.5% or higher. If no HbA1c result was available, the diagnosis was based on at least two fasting glucose levels of 126 mg/dL or higher, or at least one fasting glucose level of 126 mg/dL or higher plus a glucose level at presentation of at least 200 mg/dL.
Of the 287 patients who were identified as having unrecognized diabetes in the study, almost 70% (198) had not been diagnosed by the physician who treated them during their hospitalization. This lack of a diagnosis was indicated by patients not having received education about diabetes while hospitalized or not being discharged with a diabetes medication.
If a physician checked the HbA1c for a patient with an acute MI as part of routine clinical care, however, the likelihood that the patient would be diagnosed with diabetes was increased 18-fold, a highly statistically significant finding, Dr. Arnold said.
Dr. Arnold had no disclosures.
The registry study is the TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status) study and is sponsored by the National Institutes of Health/the National Heart Lung and Blood Institute. Genentech funded this analysis of the TRIUMPH registry data.
That 10% of patients with acute myocardial infarction (MI) were found to have undiagnosed diabetes is perhaps unsurprising, considering the known association. However, the lack of response to the diagnosis in 70% of MI patients brings to light the potential benefit of adding diabetes diagnostics and initiation of appropriate treatments to the inpatient checklist. Doing so would prompt evidenced-based care that could [affect] both the acute treatment of the primary event (via selection of interventions and medications known to benefit the diabetic patient), as well as important secondary prevention.
Dr. Claudia K. Geyer is the hospital medicine fellowship director at Central Maine Medical Center in Lewiston.
That 10% of patients with acute myocardial infarction (MI) were found to have undiagnosed diabetes is perhaps unsurprising, considering the known association. However, the lack of response to the diagnosis in 70% of MI patients brings to light the potential benefit of adding diabetes diagnostics and initiation of appropriate treatments to the inpatient checklist. Doing so would prompt evidenced-based care that could [affect] both the acute treatment of the primary event (via selection of interventions and medications known to benefit the diabetic patient), as well as important secondary prevention.
Dr. Claudia K. Geyer is the hospital medicine fellowship director at Central Maine Medical Center in Lewiston.
That 10% of patients with acute myocardial infarction (MI) were found to have undiagnosed diabetes is perhaps unsurprising, considering the known association. However, the lack of response to the diagnosis in 70% of MI patients brings to light the potential benefit of adding diabetes diagnostics and initiation of appropriate treatments to the inpatient checklist. Doing so would prompt evidenced-based care that could [affect] both the acute treatment of the primary event (via selection of interventions and medications known to benefit the diabetic patient), as well as important secondary prevention.
Dr. Claudia K. Geyer is the hospital medicine fellowship director at Central Maine Medical Center in Lewiston.
Ten percent of patients presenting with an acute myocardial infarction had undiagnosed diabetes at the time of their heart attack, underlining the importance of evaluating such patients for diabetes while they are hospitalized, investigators have reported.
The study found that 287 (10.1%) of the 2,854 patients enrolled in a 24-site U.S. acute MI registry, who were not known to have type 2 diabetes on admission, actually had diabetes, reported Dr. Suzanne V. Arnold, a cardiologist at Saint Luke’s Mid America Heart Institute, Kansas City, Mo. The data were presented at the American Heart Association’s Quality of Care and Outcomes Research conference.
The diabetes diagnosis was based on hemoglobin A1c levels of 6.5% or higher. If no HbA1c result was available, the diagnosis was based on at least two fasting glucose levels of 126 mg/dL or higher, or at least one fasting glucose level of 126 mg/dL or higher plus a glucose level at presentation of at least 200 mg/dL.
Of the 287 patients who were identified as having unrecognized diabetes in the study, almost 70% (198) had not been diagnosed by the physician who treated them during their hospitalization. This lack of a diagnosis was indicated by patients not having received education about diabetes while hospitalized or not being discharged with a diabetes medication.
If a physician checked the HbA1c for a patient with an acute MI as part of routine clinical care, however, the likelihood that the patient would be diagnosed with diabetes was increased 18-fold, a highly statistically significant finding, Dr. Arnold said.
Dr. Arnold had no disclosures.
The registry study is the TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status) study and is sponsored by the National Institutes of Health/the National Heart Lung and Blood Institute. Genentech funded this analysis of the TRIUMPH registry data.
Ten percent of patients presenting with an acute myocardial infarction had undiagnosed diabetes at the time of their heart attack, underlining the importance of evaluating such patients for diabetes while they are hospitalized, investigators have reported.
The study found that 287 (10.1%) of the 2,854 patients enrolled in a 24-site U.S. acute MI registry, who were not known to have type 2 diabetes on admission, actually had diabetes, reported Dr. Suzanne V. Arnold, a cardiologist at Saint Luke’s Mid America Heart Institute, Kansas City, Mo. The data were presented at the American Heart Association’s Quality of Care and Outcomes Research conference.
The diabetes diagnosis was based on hemoglobin A1c levels of 6.5% or higher. If no HbA1c result was available, the diagnosis was based on at least two fasting glucose levels of 126 mg/dL or higher, or at least one fasting glucose level of 126 mg/dL or higher plus a glucose level at presentation of at least 200 mg/dL.
Of the 287 patients who were identified as having unrecognized diabetes in the study, almost 70% (198) had not been diagnosed by the physician who treated them during their hospitalization. This lack of a diagnosis was indicated by patients not having received education about diabetes while hospitalized or not being discharged with a diabetes medication.
If a physician checked the HbA1c for a patient with an acute MI as part of routine clinical care, however, the likelihood that the patient would be diagnosed with diabetes was increased 18-fold, a highly statistically significant finding, Dr. Arnold said.
Dr. Arnold had no disclosures.
The registry study is the TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status) study and is sponsored by the National Institutes of Health/the National Heart Lung and Blood Institute. Genentech funded this analysis of the TRIUMPH registry data.
FROM THE AHA/QCOR ANNUAL CONFERENCE
Key clinical point: Obtaining a HbA1c level in patients presenting with an acute MI who are not known to have diabetes will help identify those who actually have the disease.
Major finding: The lab criteria for a diabetes diagnosis were met by about 10% of patients admitted with an acute MI who were not known to have diabetes – a diagnosis missed by their physicians while they were hospitalized in almost 70% of cases.
Data source: The study looked for a diagnosis of diabetes, based on HbA1c levels or fasting glucose levels, in 2,854 patients hospitalized with an acute MI who did not have a diabetes diagnosis.
Disclosures: Dr. Arnold had no disclosures. The TRIUMPH registry is sponsored by the NIH/NHLBI. Genentech funded this analysis of the TRIUMPH registry data.