AIMS: Among patients with acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at particularly high risk of recurrent cardiovascular events and premature death. We aimed to provide a descriptive overview of unadjusted analyses of patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in contemporary registries in Europe. METHODS AND RESULTS: A total of 10 registries provided data in a systematic manner on ACS patients with DM (total n =28 899), and without DM (total n= 97 505). In the DM population, the proportion of patients with ST-Segment Elevation Myocardial Infarction (STEMI) ranged from 22.1% to 64.6% (other patients had non-ST-Segment Elevation Myocardial Infarction (NSTEMI-ACS) or unstable angina). All-cause mortality in the registries ranged from 1.4% to 9.4% in-hospital; 2.8% to 7.9% at 30 days post-discharge; 5.1% to 10.7% at 180 days post-discharge; and 3.3% to 10.5% at 1 year post-discharge. Major bleeding events were reported in up to 3.8% of patients while in hospital (8 registries); up to 1.3% at 30 days (data from two registries only), and 2.0% at 1 year (one registry only). Registries differed substantially in terms of study setting, site, patient selection, definition and schedule of endpoints, and use of various P2Y12 inhibitors. In most, but not all, registries, event rates in DM patients were higher than in patients without DM. Pooled risk ratios comparing cohorts with DM vs. no DM were in-hospital significantly higher in DM for all-cause death (1.66; 95% CI 1.42-1.94), for cardiovascular death (2.33; 1.78 - 3.03), and for major bleeding (1.35; 1.21-1.52). CONCLUSION: These registry data from real-life clinical practice confirm a high risk for recurrent events among DM patients with ACS, with great variation across the different registries.

2nd Department of Medicine with Cardiology and Intensive Care Hospital Rudolfstiftung Vienna Austria

AMIS Plus Data Center Epidemiology Biostatistics and Prevention Institute University of Zurich Zurich Switzerland

AMIS Plus Data Center University of Zurich Zurich Switzerland

Cardiac Intensive Care Unit Interventional Cardiology Hospital Cardiologique Centre Hospitalier Régional et Universitaire de Lille Lille France

Cardiocenter 3rd Faculty of Medicine Charles University Prague Czech Republic

Cardiology Department Hospital La Paz Madrid Spain IdiPaz

Cardiology Department University Heart Center University Hospital Zurich University of Zurich Zurich Switzerland

Cardiology Freeman Hospital and Institute of Cellular Medicine Newcastle upon Tyne UK

Cardiology Service Hospital Universitari Vall d'Hebron Barcelona Spain

Cardiology Unit Humanitas Research Hospital Rozzano Italy

Department of Cardiology Clinical Sciences Lund University Skåne University Hospital Lund Sweden

Department of Cardiology Hospital Européen Georges Pompidou and Université Paris Descartes Paris France

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

Department of Cardiology University Hospital Antwerp Edegem Belgium

Department of Cardiovascular Sciences Laboratory of Interventional Cardiology European Hospital Rome Italy

Heart Disease Institute Bellvitge University Hospital Bellvitge Biomedical Research Institute University of Barcelona Barcelona Spain

Institut d'Investigació Sanitària Pere Virgili Cardiology Service Hospital Universitari de Tarragona Joan XXIII Tarragona Spain

Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen Germany

Pôle de L'urgence Service de d'Aide Médicale Urgente du Nord Centre Hospitalier Régional Universitaire de Lille Lille France

Swansea University Medical School Swansea Wales UK

Université Paris 06 ACTION Study Group INSERM UMRS 1166 Institut de Cardiologie Pitié Salpêtrière University Hospital Paris France

University Clinic of Internal Medicine 3 Cardiology and Angiology Medical University of Innsbruck Innsbruck Austria

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