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Diagnosing & treating diabetes in heart attack patients improves heart outcomes, study finds

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People with heart problems often have diabetes, which puts them at greater risk for heart attacks, heart failure and stroke. Now, a new study has found that ensuring heart attack patients are promptly diagnosed and treated for diabetes makes a significant difference in improving their cardiac outcomes.

For the study, researchers at the Intermountain Medical Center Heart Institute in Salt Lake City evaluated nearly 6,000 patients who were treated for heart attacks between 2002 and 2013 by Intermountain Healthcare clinicians.

Of those patients, 3,778 had no history of diabetes prior to being admitted to the hospital. After examining their blood test results, researchers, however, identified 707 patients who met criteria for a diabetes diagnosis. But of the 707, only 30 percent were actually clinically diagnosed with diabetes at that time and were receiving treatment, either at the time of hospitalization or soon thereafter, researchers found.

Researchers examined adverse outcomes for patients diagnosed and treated for diabetes compared to those who met the criteria for diabetes, but weren't diagnosed. They found that deaths, repeat heart attacks, heart failure admissions and strokes were all significantly reduced among patients who'd been diagnosed.

Diabetic patients who were undiagnosed and/or untreated had an increased risk of complications and death.
Results of the study were presented at the American Heart Association's 2015 Scientific Session in Orlando on Nov. 8.

"We've known for over a decade that patients with diabetes are at a much higher risk of suffering a heart attack than those who don't have diabetes," said Viet Le, PA-C, a researcher for the Intermountain Heart Institute at Intermountain Medical Center. "Unfortunately, with the worry of treating the heart attack, we haven't directed our full attention to assessing the presence of diabetes in heart patients to make sure they receive treatment."

A previous study by the Intermountain Heart Institute at Intermountain Medical Center found that any level of impaired blood glucose is associated with poorer cardiovascular outcomes. This updated study confirms that heart attack patients with diabetes, whether previously or newly diagnosed, face a greater risk of future heart problems.

Le recommends that hospitals and physicians implement a new process to make sure blood tests looking for diabetes are administered to every heart attack patient upon admission. If the test confirms diabetes, the physician should begin treatment for the diabetes immediately — in addition to the care being provided for the patient's heart condition.

"There's a clear way we can easily make a huge difference for heart patients," Le said. "Hospitals and physicians should implement a process to screen all patients who present with a heart attack for diabetes, and if the patient has diabetes, we should make sure they receive treatment. A simple blood test administered upon admission is all it takes."

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Members of the research team included: Viet Le; Stacey Knight: Jeffrey Anderson, MD; Donald Lappé, MD; Heidi May, Benjamin Horne, and Brent Muhlestein, MD.

Intermountain Medical Center is the flagship medical facility for the Intermountain Healthcare system, based in Salt Lake City.

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