Prevalence of diabetes is increasing worldwide and outcomes after ACS are thought to improve. We assessed the prevalence of DM, previously known (known-DM) or newly-diagnosed (new-DM), in all patients (n=1,017, males 66.6%) admitted for ACS at the Intensive Coronary Care Unit of the Verona University Hospital from 1/1/2015 to 12/31/2016. DM was ascertained according to previous diagnosis, glucose-lowering therapy at admission/discharge or random plasma glucose ≥11.1 mmol/L. The association of DM with in-hospital death, infectious/cardiorespiratory complications, duration and costs of hospitalization was tested in all patients and separately in known-DM and new-DM. The prevalence of DM was 27.2% (74.1% known-DM; 25.9% new-DM). In-hospital death rate was 4.72%. Compared to nondiabetic patients, those with DM showed an increased risk of death (7.6 vs. 3.6%; OR 2.17 95% CI, 1.20-3.90) and complications (34.4 vs. 23.9%; OR 1.67, 1.23-2.28), a longer hospital stay (median[IQR], 11 [7-17] vs. 8 [6-13] days), higher hospitalization costs (mean±SD, € 10,033±7,626 vs. 8,513±6,363) and more need of rehabilitation at discharge (10.8 vs. 5.9%); P<0.for all comparisons. After multivariable adjustment (age, sex, BMI, e-GFR, LVEF, previous MI, lipid-lowering and anti-hypertensive drugs), DM remained an independent predictor of in-hospital death (OR 5.81, 1.31-25.7) but not complications (OR 1.14, 0.78-1.69). All study outcomes resulted significantly worse in new-DM vs. known-DM. In the former, ORs for in-hospital death and complications vs. nondiabetic controls were 2.40 (0.96-6.02) and 1.71 (0.99-2.96), respectively, while in known-DM figures were 2.09 (1.09-3.99) and 1.66 (1.18-2.33), respectively. These data highlight the extremely high frequency of DM in ACS and underscore the urgent need of strategies to anticipate DM diagnosis in patients at high cardiovascular risk.


M. Dauriz: None. L. Drezza: None. L. Santi: None. A. Altomari: None. E. Rinaldi: None. S. Tardivo: None. C. Bovo: None. F. Ribichini: None. E. Bonora: None.

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