IMPACT OF TYPE 2 DIABETES IN NON ST-ELEVATION MYOCARDIAL INFARCTION (NSTEMI)

Objetives: The aim of this work is to expose the experience of our center in managing severe multi vessel coronary artery disease in diabetic NSTEMI patients. Methods:This is a retrospective study of 105 patients admitted for a high risk non ST-Elevation Myocardial Infarction (NSTEMI) to the cardiology department of the military hospital, Rabat, Morocco. Data was collected from january 2013 to december 2014. We enrolled patients in two groups: Group 1: diabetic patients (N 53) and Group 2: non diabetic patients (N 52). Results: The mean age was almost comparable between the 2 groups: 62 years in diabetics against 60 years in non-diabetics. The mean diabetes duration was about 8.6 years.Diabetic patients are more likely to develop arterial hypertension; smoking is the most important cardiovascular risk factor in non-diabetic group. Tri-truncular coronary lesion was more frequent in diabetics (55%), whereas non-diabetic patients had more mono-truncular lesions (53%). 59% of diabetic patients underwent PCI vs 53 % in non diabetic group, 26% of diabetic patients underwent CABG. 15% of diabetic group and 16% of non diabetic group were managed by medical treatment only. For in-hospital MACE, there were no signicant differences in outcomes between the 2 groups. (Group1 : 10,4% vs Group 2 : 10,5%, p :0,6). Conclusions: In diabetic NSTEMI patients, coronary artery disease was more severe; in our center, PCI was non inferior in term of intra hospital MACE compared to CABG.