Clinical characteristics and in‐hospital mortality among insulin pump users with acute coronary syndrome in the predominantly open‐loop era: A UK ‐wide MINAP registry analysis
Authors' conclusion
CSII users admitted with ACS represented a more complex group with haemodynamic compromise and higher unadjusted mortality.
Study context
- Population
- Adults aged ≥18 years with confirmed ACS and insulin-treated diabetes, Myocardial Ischaemia National Audit Project registry (England and Wales)
- Participants
- 3,321 vs 30,593
- Exposure
- Continuous subcutaneous insulin infusion (CSII) vs MDI
- CSIIn = 3,321
- MDIn = 30,593reference
- Outcome
- In-hospital mortality
Methodological detailsregistry analysis, England and Wales
- Registry analysis
- England and Wales
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Cardiogenic shock
Pulmonary oedema
Poor left ventricular systolic function
STEMI
Predictors of in-hospital mortality among CSII users
- Cardiogenic shock, aOR
- 10.46 (95% CI 6.95-15.81)
- Poor left ventricular function, OR
- 4.15 (95% CI 2.69-6.53)
- Basal crepitations, OR
- 1.94 (95% CI 1.40-2.67)
- Pulmonary oedema, OR
- 1.56 (95% CI 1.05-2.28)
- Higher systolic blood pressure, OR per 10 mmHg
- 0.86 (95% CI 0.82-0.90)
- Multivariable logistic regression
Gradient boosting machine (GBM) model performance for mortality among CSII users
- AUC
- 0.85
- Brier score
- 0.088
Original publication
Clinical characteristics and in‐hospital mortality among insulin pump users with acute coronary syndrome in the predominantly open‐loop era: A UK ‐wide MINAP registry analysis. Diabet Med. Published 2 July 2026. doi:10.
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