Evidence mapPaperPMID 39358593Full record

ArticleDiabetologia2024

Addressing disparities in the long-term mortality risk in individuals with non-ST segment myocardial infarction (NSTEMI) by diabetes mellitus status: a nationwide cohort study.

Andrew Cole, Nicholas Weight, Shivani Misra, Julia Grapsa, Martin K Rutter, Zbigniew Siudak, Saadiq Moledina, Evangelos Kontopantelis, Kamlesh Khunti, Mamas A Mamas

Erratum issuedAbstract read
In one paragraph

Article in Diabetologia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Andrew ColeKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Newcastle-under-Lyme, UK.ORCID http://orcid.org/0000-0002-9595-0003
Nicholas WeightKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Newcastle-under-Lyme, UK.ORCID http://orcid.org/0000-0001-5952-7542
Shivani MisraDivision of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Julia GrapsaCardiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0003-4620-6234
Martin K RutterDiabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK.ORCID http://orcid.org/0000-0001-6380-539X
Zbigniew SiudakInstitute of Public Health, Jagiellonian University Medical College, Kraków, Poland.ORCID http://orcid.org/0000-0002-8033-3977
Saadiq MoledinaKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Newcastle-under-Lyme, UK.ORCID http://orcid.org/0000-0001-6934-7684
Evangelos KontopantelisDivision of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK.ORCID http://orcid.org/0000-0001-6450-5815
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.ORCID http://orcid.org/0000-0003-2343-7099
Mamas A MamasKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Newcastle-under-Lyme, UK. m.mamas@keele.ac.uk.ORCID http://orcid.org/0000-0001-9241-8890

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisThe aim of this study was to investigate how diabetes mellitus affects longer term outcomes in individuals presenting to hospital with non-ST segment elevation myocardial infarction (NSTEMI).

methodsWe analysed data from 456,376 adults hospitalised between January 2005 and March 2019 with NSTEMI from the UK Myocardial Ischaemia National Audit Project (MINAP) registry, linked with Office for National Statistics death reporting. We compared outcomes and quality of care by diabetes status.

resultsIndividuals with diabetes were older (median age 74 vs 73 years), were more often of Asian ethnicity (13% vs 4%) and underwent revascularisation (percutaneous coronary intervention or coronary artery bypass graft surgery) (38% vs 40%) less frequently than those without diabetes. The mortality risk for those with diabetes compared with those without was significantly higher at 30 days (HR 1.19, 95% CI 1.15, 1.23), 1 year (HR 1.28, 95% CI 1.26, 1.31), 5 years (HR 1.36, 95% CI 1.34, 1.38) and 10 years (HR 1.39, 95% CI 1.36, 1.42). In individuals with diabetes, higher quality inpatient care, assessed by opportunity-based quality indicator (OBQI) score category ('poor', 'fair', 'good' or 'excellent'), was associated with lower mortality rates compared with poor care (good: HR 0.74, 95% CI 0.73, 0.76; excellent: HR 0.69, 95% CI 0.68, 0.71). In addition, compared with poor care, excellent care in the diabetes group was associated with the lowest mortality rates in the diet-treated and insulin-treated subgroups (diet-treated: HR 0.64, 95% CI 0.61, 0.68; insulin-treated: HR 0.69, CI 0.66, 0.72). CONCLUSION/

interpretationIndividuals with diabetes experience disparities during inpatient care following NSTEMI. They have a higher risk of long-term mortality than those without diabetes, and higher quality inpatient care may lead to better long-term survival.

Indexed as

Diabetes MellitusNon-ST Elevated Myocardial InfarctionAgedAged, 80 and overCohort StudiesFemaleHospitalizationHumansMaleMiddle AgedPercutaneous Coronary InterventionRegistriesRisk FactorsUnited KingdomAcute myocardial infarctionCardiovascular epidemiologyDiabetes mellitusMortalityNon-ST elevation myocardial infarctionQuality of care

Identifiers

PMID39358593
PMCPMC11604752

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.