Admission plasma glucose level among non-diabetic patients sustaining acute coronary syndrome

Abstract

Background: Stress hyperglycemia occurs in 5−30% of patients with apoplexy, myocardial infarction, sepsis, trauma and other critical illnesses, and it correlates with poor outcome. Aims: assessment of the prevalence of admission hyperglycemia among acute coronary syndrome patients and its impact on the outcome. 

Patients and methods: Observational case control study had recruited 80 non-diabetic adults’ patients (43 males, 37 females) who were randomly selected after admission to the CCU/department of medicine/ Al-Yarmouk Teaching Hospital in the period from March to October 2009 because of acute coronary syndrome. Detailed history and physical examination were done, body mass index, waist-hip-ratio were recorded, venous blood sample were taken from patients to measure plasma glucose level and HbA1c; ECG and echocardiogram were done to all patients included in the study.

 Results: 80 patients (43 males, 37 females) completed the study, their age groups ranging from 37-76 years, 3 patients were excluded from the study (2 male, 1 female) when they found to have high HbA1c ( ≥6.5%). 16 patients (20.6% of total no.) (7 male, 9 female) with a mean age of (62.19±7.17) were found to have casual admission (stress) hyperglycemic, a p value <0.05. Hyperglycemia is more likely associated with a female gender, advancing age, higher BMI, android pattern of body fat distribution, and higher killip classes (III, IV). Conclusions: Casual admission (stress) hyperglycemia is not uncommon among non- diabetic adults admitted for acute coronary syndrome. Poorer outcome in patients with ACS is more likely among those with higher glycemic level, especially with advancing age, female gender and increased total body fat.