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Severe hypoglycaemia ups ACS risk in diabetics

17 Oct 2019

The risk of acute coronary syndrome (ACS) appears to be elevated following episodes of severe hypoglycaemia, a recent study has found.

Researchers performed a retrospective, population-based analysis on the data of 7,909,626 diabetes patients (aged 35 years; 41 percent male). The absolute risk of ACS was defined as the need for emergency percutaneous coronary intervention following severe hypoglycaemia.

Over 5,087,611,521 person-days of follow-up, 37,486 cases of ACS were reported. The resulting absolute risk was 2.9 per 1,000 person-years. In those with vs without type 1 diabetes, the corresponding rates were 2.1 and 3.0 per 1,000 person-years, respectively.

Within 2 years, 48,118 at-risk patients experienced a severe hypoglycaemic episode. These patients were more likely than their no-episode counterparts to develop ACS (3.0 vs 2.7 per 1,000 person-years). They also tended to be older and more likely to receive insulin therapy, antiplatelet drugs and anticoagulants.

Adjusted regression analysis confirmed that severe hypoglycaemia was a significant risk factor for ACS (hazard ratio, 1.016, 95 percent CI, 1.012–1.021).

This ACS risk changed over time, varying according to the time elapsed after the severe hypoglycaemia episode. At 10 days after such an episode, for instance, the absolute risk of ACS was 10.6 per 1,000 person-years. This dropped to 2.2 and 2.5 per 1,000 person-years after 11–90 and 91–365 days had elapsed, respectively.

The present findings indicate that severe hypoglycaemia needs to be monitored and treated well in patients with diabetes, said researchers. Future studies are needed to better characterize the time interval after hypoglycaemia during which ACS risk should be tightly managed.

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Most Read Articles
Pearl Toh, 20 Nov 2019
The trade-off between the risk of ischaemic vs bleeding events may be different between Asian and non-Asian patients, which warrants careful consideration when deciding on the duration of antiplatelet therapy following a percutaneous coronary intervention (PCI), according to a presentation at ESC Asia Congress 2019.
4 days ago
Participating in a long-distance skiing event may help lower the risk of hypertension, with the number of completed races showing a weak association with the risk, a study has found.
06 Sep 2019
Hypertensive adults with lower plasma zinc concentration are at increased risk of haemorrhagic stroke, especially those with higher body mass index or lower plasma copper levels, a study has found.
06 Jan 2020
Target organ damage appears to be more noticeable in patients affected by primary aldosteronism than those affected by arterial hypertension without primary aldosteronism, suggests a study, adding that specific treatment can ease such condition.