• NEWS . 07 Dec 2020
  • Diabetes linked to longer-term antiplatelet therapy and higher ischaemic risk: Insights from the EPICOR Asia Study

  • The EPICOR Asia (Long-Term Follow-up of Antithrombotic Management Patterns in Acute Coronary Syndrome Patients in Asia) registry is a prospective, observational study of 12,922 patients with acute coronary syndrome (ACS) surviving to discharge, from eight countries/regions in Asia. In a recent analysis, researchers sought to evaluate the impact of diabetes mellitus (DM) on the use of antiplatelet agents and cardiac events (composite of death, myocardial infarction and stroke, with or without any revascularization; individual components; and bleeding) in ACS patients. 

    A total of 3,162 patients with DM and 9,602 patients without DM were included. Significant baseline differences were seen between patients with DM and patients without DM for age, sex, body mass index, cardiovascular history, angiographic findings and use of percutaneous coronary intervention.

    Results showed that at discharge, ≈90% of patients in each group received dual antiplatelet therapy. At 2-year follow-up, more patients with DM were still receiving DAPT than those without DM (60% vs 56%). DM was associated with increased risk of ischaemic but not major bleeding events. Advanced age (≥65 years) and use of diuretics at discharge were found to be independent predictors of the composite endpoint of death, myocardial infarction and stroke in patients with DM. 

    The study concluded that patients with DM are at increased risk of ischaemic events, which further indicates an unmet need for improved antithrombotic treatment strategies. 

    Reference: 
    Guan S, et al. Impact of diabetes mellitus on antithrombotic management patterns and long-term clinical outcomes in patients with acute coronary syndrome: Insights from the EPICOR Asia study. J Am Hart Assoc 2020. doi:10.1161/JAHA.119.013476. [Epub ahead of print].