Is HBA1C reliable in diagnosing diabetes in the acute phase of acute coronary syndromes?

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Hospitalization due to acute coronary syndromes (ACS) usually is the occasion that leads to diagnosis of type 2 diabetes mellitus (T2DM). Current literature suggests that the severity of the ACS could be associated with the presence and the severity of DM. Purpose To study the reliability of HbA1c in the diagnosis of T2DM in the acute phase of ACS, as well as the presence of possible correlation between the HbA1c and the severity of ACS. Methods We evaluated 160 consecutive patients admitted due to ACS. HbA1c was measured on day 1 and day 90. HbA1c >6.5% was used to diagnose T2DM and HbA1c 5.7-6.4% was used to diagnose pre-diabetes. The severity of ACS was assessed via Gensini score. Results are interpreted as mean ± SD. Comparisons were made by one way ANOVA(p < 0.05 was regarded statistically significant).Spearman’s rank correlation was used to study the correlation between Gensini score and the other parameters. Results Mean age was 59.73 ± 12.21 years. 103/160(64.37%) were male and 57/160(35.63%) were female. 19/160(11.87%) were diagnosed as STEMI and 141/160(88.13%) as NSTEMI. Mean BMI was 29.55 ± 8.41 kg/m2 and mean Hb 12.62 ± 2.08 g/dl. On day 1, 43/160 (26.87%) had HbA1c > 6.5% and 41/160(25.62%) HbA1c 5.7-6.4%. On day 90, 28/160 (17.5%) had HbA1c > 6.5% and 52/160(32.5%) HbA1c 5.7-6.4%. Gensini score varied between 0-144 with mean value 40.26 ±35.9. A strong correlation was found between Gensini score and HbA1c on admission as well as on day 90 (rho-0.36, p < 0.05 and rho = 0.32, p < 0.05 respectively). Conclusion HbA1c seems to be reliable in the identification of pre-diabetes but not T2DM in the acute phase of ACS. The correlation of the severity between ACS and HbA1c seems to relate with the worst prognosis of T2DM patients.