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Masters Thesis | Medical Science | India | Volume 12 Issue 8, August 2023 | Popularity: 4.9 / 10

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A Study on the Correlation between Admission Day Glycemic Status and in - Hospital Outcome of Acute Coronary Syndrome in Diabetic and Non Diabetic Patients

Apoorva, N S Biradar

Abstract: Context: In Acute coronary syndrome, admission hyperglycemia is associated with adverse cardiovascular events in diabetes and non - diabetic patients. Background: Type 2 Diabetes mellitus is on increasing trend globally and specially in India. Incidence of Coronary artery disease is higher in diabetics. Incidence of morbidity and mortality are higher in first few days following Acute Coronary Syndrome requiring hospitalisation. Hyperglycaemia on admission is a common observation in both diabetics and non diabetics. Admission hyperglycemia seems to be independent predictor of adverse outcome. Objective: To assess the prognosis of patients with acute coronary syndrome comparing admission blood sugar and HbA1c values. Method: The study group comprised of patients admitted in our ICU with acute coronary syndrome. The study included all patients who fulfilled the inclusion criteria irrespective of diabetic status. The study group included patients both known diabetics and patients who were not known diabetic. They were closely monitored during hospital stay. Result: The mean blood sugar, on admission, in diabetic patients was 246.94 mg/dL and in non diabetic patients was 192.58 mg/dL. The mean HbA1c level in diabetic patients was 7.36% and in non diabetic patients was 6.37%. In our study group 51% had STEMI, 32% had NSTEMI, and 17% had Unstable Angina. The mean RBS in the patients who recovered completely was 191.15 mg/dL, while in patients with poor outcome was 297.61 mg/dL. The mean HbA1c in patients recovered completely was 6.6% while in patients with poor outcome was 7.76%. In patients presented with high RBS and HbA1c, 45% had adverse cardiac events (ACE). In our study, in diabetic patients with RBS?140 mg/dL, total of 30 patients had ACE, while only 3 patients with RBS< 140mg/dL had ACE. With HbA1c levels in diabetic patient similar statistics were seen. In not a known case of diabetic patients, 11 patients who had ACE presented with RBS? 140 mg/dL, while 1 patient presented with RBS<140 mg/dL.6 ACS patient presented with HbA1c ? 6.5% had ACE while 6 patient presented with HbA1c <6.5 %. Conclusion: Admission RBS and HbA1c were significantly high in patients with adverse cardiac events irrespective of history of diabetes. Patients with no history of diabetes when presented with an elevated admission RBS have significant adverse cardiac events. Higher HbA1c value in a diabetic population is a predictor of adverse cardiac event in acute coronary syndrome. Admission hyperglycemia seems to be a powerful predictor of ACE in ACS patients even in subjects without diabetic history. Acute disturbances in glucose levels as indicated by high admission RBS appears to be of greater importance in predicting short term outcome. Hence admission blood sugar value in ACS patients can be taken as an indicator of high risk subjects so that close monitoring for early detection of ACE and appropriate measures are taken.

Keywords: Diabetes; Acute Coronary Syndrome; HbA1c; Admission blood sugar; Adverse Cardiac Event

Edition: Volume 12 Issue 8, August 2023

Pages: 1291 - 1295

DOI: https://www.doi.org/10.21275/SR23811111533

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