Study to Evaluate Correlation of Blood Sugar Level and Glycosylated Haemoglobin at the Time of Admission with Severity of Acute Coronary Syndrome in Diabetic Patients

Abstract

Aim: To study the clinical profile of diabetic patients who present with Acute Coronary Syndrome (ACS) for the first time, to correlate the Blood Sugar Level (BSL) and Glycosylated hemoglobin (HbA1C) at the time of admission and the severity of acute coronary syndrome; and to assess the correlation between tight glycemic control of diabetics based on HbA1C estimation and presence of end organ damage in diabetics. Materials and Methods: The study was undertaken at our medical college in the medicine department. 64 adult patients who are known diabetics or detected for the first time presenting in outpatient department or emergency department as acute coronary syndrome were studied. Study period was 2 years from January 2011 to December 2012. Results: The study showed a definite male preponderance, with 56.23% males as compared to 43.73% females. Atypical presentations of acute coronary syndrome were more common as compared to typical chest pain (34.37%). Chest pain commonly is prevalent in younger age group. 95.30% of the patient had some or other associated risk factors like hypertension (59.37%), smoking (26.56%), obesity (15.62%) or dyslipidemia (65.62%). ST elevation MI was the commonest presentation (73.40%) and involvement of anterior wall was common (36.20%). On admission BSL (Blood Sugar Level) was not found to have a definite prognostic value in predicting outcome in diabetic patients with acute coronary syndrome. Impaired glycosylated haemoglobin was found to be an independent risk factor and had a definite prognostic value in predicting outcome. Diabetic patient with acute coronary syndrome had LV dysfunction, cardiac rhythm abnormalities, cardiogenic shock and are likely to be readmitted, thus having worst morbidity as well as mortality. Conclusion: The primary aim of this study was to study correlation of blood sugar level and glycosylated haemoglobin at the time of admission with severity of acute coronary syndrome and to study clinical profile of diabetic patients with due consideration to complications which are related to diabetes.