@article {Sanchez264, author = {P L Sanchez and J L Morinigo and P Pabon and F Martin and I Piedra and I F Palacios and C Martin-Luengo}, title = {Prognostic relations between inflammatory markers and mortality in diabetic patients with non-ST elevation acute coronary syndrome}, volume = {90}, number = {3}, pages = {264--269}, year = {2004}, doi = {10.1136/hrt.2002.007443}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective: To determine the differences in the inflammatory status between diabetic and non-diabetic patients and to evaluate the usefulness of C reactive protein, fibrinogen, and leucocyte count as predictors of death in diabetic patients with unstable coronary disease.Design: Nested case-control comparisons of the inflammatory status between diabetic and non-diabetic patients. Prospective cohort analysis of C reactive protein concentration, fibrinogen concentration, and leucocyte count as predictors of cardiovascular death in diabetic patients.Setting: Coronary care unit in Spain.Participants: 83 diabetic patients with non-ST elevation acute coronary syndrome and 83 sex and aged matched patients selected from 361 non-diabetic patients with non-ST elevation acute coronary syndrome.Main outcome measures: Plasma concentrations of C reactive protein and fibrinogen, and leucocyte count. Investigators contacted patients to assess clinical events.Results: Concentrations of C reactive protein and fibrinogen, and leucocyte count on admission were higher in diabetic than in non-diabetic patients (7 mg/l v 5 mg/l, p  =  0.020; 3.34 g/l v 2.90 g/l, p  =  0.013; and 8.8 {\texttimes} 109/l v 7.8 {\texttimes} 109/l, p  =  0.040). Among diabetic patients, these values were also higher in those who died during the 22 month follow up (13 mg/l v 6 mg/l, p  =  0.001; 3.95 g/l v 3.05 g/l, p \< 0.001; and 11.4 {\texttimes} 109/l v 8.4 {\texttimes} 109/l, p  =  0.005). After adjustment for confounding factors, diabetic patients in the highest tertile of C reactive protein had a hazard ratio for cardiovascular death of 4.51 (95\% confidence interval (CI) 1.62 to 12.55). Similar hazard ratios were for fibrinogen 3.74 (95\% CI 1.32 to 10.62) and for leucocyte count 3.64 (95\% CI 1.37 to 9.68).Conclusions: Inflammation appears more evident in diabetic than in non-diabetic patients with acute coronary syndrome. C reactive protein concentration, fibrinogen concentration, and leucocyte count constitute independent predictors of cardiovascular death in diabetics with unstable coronary disease.}, issn = {1355-6037}, URL = {https://heart.bmj.com/content/90/3/264}, eprint = {https://heart.bmj.com/content/90/3/264.full.pdf}, journal = {Heart} }