O202 Trends For Smoking Versus Diabetes Mellitus Among Acute Coronary Syndrome Patients Over A 15-Year Period
Introduction: Diabetes mellitus and smoking habit, separately or in combination, are well-known major risk factors for coronary artery disease (CAD). Objectives: To study the trend for non-diabetic smoking versus non-smoking diabetes mellitus in patients presenting with acute coronary syndromes (ACS) over a 15-year period in a single cardiology center in a rapidly developing Middle Eastern country. Methods: All patients hospitalized with ACS between January 1995 and December 2010 were included and categorized based on whether they were smokers but not diabetic (Smokers) or diabetics but not Smokers (Diabetics). The collected data for each group were analyzed and compared. The study was divided by a 4- year apart into 4 eras. Results: During the study period, 14,975 ACS cases were admitted, of them 3903 (45%) were Smokers and 4711 (55%) were Diabetics. In comparison to Diabetics, Smokers were 11 years younger , had more STEMI (54% vs 29%, p< 0.001), had fewer rates of hypertension, dyslipidemia, obesity and prior revascularizations (p¼0.001 for all). The hospital use of Beta blockers (55% vs 47%), antiplateles (97% vs 95%), thrombolytics (40% vs 17%) and coronary angiography(21% vs 17%) were more frequent among Smokers in comparison to Diabetics (p<0.001 for all). Whereas, ACE inhibitors use was higher among Diabetics (37% vs 29%, p<0.001). The rates of hospital stroke and mortality were signiﬁcantly higher among Diabetics group (0.6% vs 0.1% and 8% vs 3%, respectively). There was upward trend for smoking from 16% in (1995-1998) reaching 39% in (2007-2010) and for diabetes from 9% in (1995-1998) reaching 41% in (2007-2010). However the mortality rates showed downward trends from 4.3% to 1.5% for smoking group and from 15.3% to 5% for diabetics group between (1995-1998) and (2007-2010). Conclusion: The rate of each risk factor (smoking or diabetes mellitus) is increasing substantially in patients with ACS. Although the mortality rate differs in each group, DM alone is associated with higher mortality with insufﬁcient use of evidence –based therapies.