Comparison of the Clinical Manifestations of Acute Coronary Syndrome Between Diabetic and Non-diabetic Patients: A Systematic Review and Meta-Analysis.

Autor:	Tabowei G; Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA., Dadzie SK; Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA., Ahmed S; Cardiology, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, PAK., Lohana M; Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK., Shahzad M; Medicine, Sialkot Medical College, Sialkot, PAK., Zehra SN; Medicine, Liaquat Medical College, Karachi, PAK., Zubair M; Medicine, Sialkot Medical College, Sialkot, PAK., Khan A; Critical Care Medicine, United Medical and Dental College, Karachi, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 11; Vol. 16 (7), pp. e64311. Date of Electronic Publication: 2024 Jul 11 (Print Publication: 2024).
DOI:	10.7759/cureus.64311
Abstrakt:	The presentation of acute coronary syndrome (ACS) in patients with type 2 diabetes mellitus (T2DM) may differ from that of non-diabetic patients, potentially leading to delayed diagnosis and treatment. This meta-analysis aimed to compare the clinical presentation of ACS between diabetic and non-diabetic patients. A systematic search of PubMed, Excerpta Medica database (EMBASE), and Web of Science databases was conducted for observational studies published from January 2010 onwards. Studies comparing ACS symptoms between diabetic and non-diabetic patients were included. The odds ratio (OR) with 95% confidence intervals (CI) was calculated using a random-effects model. Eight studies with a total of 29,503 patients (23.03% diabetic) were included. Diabetic patients were significantly less likely to present with chest pain compared to non-diabetic patients (OR: 0.43, 95% CI: 0.30 to 0.63, p<0.001). Anxiety (OR: 2.20, 95% CI: 1.17-4.14), shortness of breath (OR: 1.49, 95% CI: 1.11-2.01), and neck pain (OR: 1.62, 95% CI: 1.03-2.54) were significantly more common in diabetic patients. Sweating/cold sweat was less common in diabetics (OR: 0.60, 95% CI: 0.34-1.07), though not statistically significant. Other symptoms showed minimal differences between groups. High heterogeneity was observed across studies for most symptoms. This meta-analysis demonstrates that diabetic patients with ACS are less likely to experience typical chest pain and more likely to present with atypical symptoms such as anxiety, shortness of breath, and neck pain. These findings emphasize the need for healthcare providers to maintain high vigilance for atypical ACS presentations in diabetic patients. Tailored diagnostic approaches, modified triage protocols, and enhanced patient education are crucial to improving the timely diagnosis and treatment of ACS in this high-risk population. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Tabowei et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu