Glycaemic Status On Admission In Patients With Acute Coronary Syndrome

J Indrakumar,M.G.C.P Marasinghe

doi:10.4038/sljcc.v1i1.939

Abstract

Introduction: In patients with acute coronary syndrome (ACS), hyperglycemia is a predictor of immediate and long-term cardiovascular mortality. Abnormal glucose regulation is present in the majority of these patients and is unrecognized in up to half of the cases. The objective of this study was to assess the glycaemic status of patients on admission with ACS.Methodology: Patients presenting with chest pain and falling into one of the acute coronary syndromes (STEMI, NSTEMI, and UA) were allocated in to two groups based on past history of Diabetes. Diagnosed Diabetic patients who were not on treatment were excluded from the study. Admission RBS and next day FBS were recorded in all patients. Results: 102 patients were enrolled for the study. Mean admission random blood sugar(RBS) and fasting blood sugar(FBS) of diabetic patients who were on treatment were significantly higher (308, 203 mg/dl) than that of patients without a past history of Diabetes (135, 111 mg/dl) P < 0.001. Out of the patients with diabetes, 88% had a RBS more than 140mg/dl and 59% had more than 200 mg/dl on admission. Patients without past history of Diabetes, these values were 32% and 5% respectively. 45% of patients without past history of Diabetes had impaired FBS values (100 - 126 mg/dl) and 17% had a FBS value more than 126 mg/dl. The blood glucose values (RBS and FBS) of each of the three types of ACSs (STEMI, NSTEMI, UA) did not show a significant difference among them. Conclusions: Hyperglycaemia is a major problem in our patients with and without a past history of diabetes when they present with ACS. Therefore prompt attention is necessary on blood glucose control in all patients, irrespective of the past status of diabetes. It is important to follow up the patients with abnormal blood glucose values and without a past history of diabetes , to detect the development of Diabetes.Keywords: acute coronary syndrome; glycaemic control; hyperglycaemiaCitation: Indrakumar J, Marasinghe MCGP. Glycaemic Status On Admission In Patients With Acute Coronary Syndrome. Sri Lanka Journal of Critical Care 2009;1:25-28DOI: 10.4038/sljcc.v1i1.939

Highlights

In patients with acute coronary syndrome (ACS), hyperglycemia is a predictor of immediate and long-term cardiovascular mortality
Fasting blood sugar(FBS) of diabetic patients who were on treatment were significantly higher (308, 203 mg/dl) than that of patients without a past history of Diabetes (135, 111 mg/dl) P < 0.001
Hyperglycaemia is a major problem in our patients with and without a past history of diabetes when they present with ACS

Summary

Introduction

In patients with acute coronary syndrome (ACS), hyperglycemia is a predictor of immediate and long-term cardiovascular mortality. Abnormal glucose regulation is present in the majority of these patients and is unrecognized in up to half of the cases. In patients with acute coronary syndrome (ACS) 1, hyperglycemia has been shown to be a predictor of immediate and long-term cardiovascular mortality. Abnormal glucose regulation is present in the majority of ACS patients and is unrecognized in up to half of the cases 3. The entity of impaired fasting glucose (IFG) is an independent factor of cardiovascular mortality, it has been associated with a doubling of the risk of in-hospital mortality in ACS 5, 6. It has been found that stress hyperglycaemia due to myocardial infarction is associated with an increased risk of in-hospital mortality in patients with and without diabetes 7. SLJCC 2009 Vol 1 No 1 combination of fasting blood sugar (FBS)

Objectives

Methods

Results

Conclusion