Background: Diabetes has been shown to be associated with increased mortality and
morbidity worldwide. This study explored whether diabetes significantly impacts on outcomes
among elderly adults with cardiovascular disease (CVD) admitted to a specialist hospital in Southern
Design: A prospective cohort study of 411 patients admitted to hospital after a cardiac event between
2008 and 2010.
Methods: The primary end point was death by all causes during the follow up period of 6 months
from admission. All hospital death reports matched those reported by the Brazilian Public Health
Death Records. Cumulative probability of survival by Kaplan-Meier plot and log rank tests compared
hospital admissions with or without diabetes. Adjusted and unadjusted hazard ratios (HR) for
overall mortality were calculated.
Results and Conclusions: The mean ± SD age of the subjects was 69.8 years ± 14 and 50% were
men. Overall study mortality was 8.7%. Half of the deaths occurred in patients ≥80 years (p=0.001).
Diabetes was associated with 53% of the overall mortality (p<0.01) and 79% of the CVD-related
deaths (p<0.03). The adjusted HR was 2.88 (95% CI 1.42–5.84) for diabetic patients aged ≥80 years.
In conclusion, the results suggest that elderly patients of European origin with diabetes residing in
Southern Brazil admitted to hospital for specialist CVD treatment have poorer survival and higher
risk of further CVD events 6 months after hospital discharge compared with those without. We recommend
that better strategies for managing CVD risk factors among elderly diabetic patients from
similar patient cohorts in Brazil are necessary.