Key result
Prediabetes linked to ~3-fold higher risk of reduced LVEF after acute coronary syndrome.
Why the study?
Hyperglycaemia in patients with acute myocardial infarction, including non-diabetics, is associated with increased mortality and morbidity, but its relation to outcomes in non-diabetic ACS patients requires further assessment.
Observational (n=81)
No
Absolute Event Rate: 81.8% vs 27%
p-value: p=<0.0001
In recent years, much attention has been given to the evidence that the concomitant occurrence of hyperglycaemia in patients admitted to intensive care units with an acute myocardial infarction (MI) enhances the risk of mortality and morbidity, whether the patient as DM or not. In some cases, the elevation of sugar could simply be a marker of pre-existing, but not yet detected type 2 diabetes or impaired sugar tolerance (IGT). This may mean that besides being causal, elevated sugar also could be a marker of existing insulin resistance and/or beta-cell failure that may contribute to the poor prognosis through other mechanisms. However, a positive association between hyperglycaemia at the time of the event and subsequent mortality from MI has frequently been reported. Consequently, understanding the possible mechanisms through which hyperglycemia worsens the prognosis of a MI and the effectiveness of its control during acute coronary syndrome seems to be of great relevance. AIM: To assess the relation of increased blood sugar level with outcome in patients of acute coronary syndrome (ST Elevation Myocardial Infarction and Non ST Elevation Myocardial Infarction) in non-diabetic subjects. Material and methods: The present study type was a prospective observational type of study conducted to study the relation of increased blood sugar level with outcome in patients of acute coronary syndrome (ST Elevation Myocardial Infarction and Non ST Elevation Myocardial Infarction) in non-diabetic subjects among 81 cases in Krishna Hospital and Medical Research Centre, Department of Medicine, KIMS over a period of 18 months (October 2019 to March 2021). Results: A total of 81 patients with a diagnosis of ACS without diabetes mellitus were included in the present prospective observational descriptive study. Out of the 54.32% who had aged more than 60 years, 33.33% had between 46 to 60 years and 12.35% had between 30 to 45 years. Conclusion: Our study was a prospective study .......
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Vaibhav Vijay Rane (2022) conducted an observational in Acute Coronary Syndrome (STEMI and NSTEMI) (n=81). Prediabetes (HbA1c 5.7-6.4%) vs. Normal HbA1c (<5.7%) was evaluated on Adverse outcome (Ejection Fraction < 40%) (p=<0.0001). Prediabetes (HbA1c 5.7-6.4%) in previously non-diabetic patients with acute coronary syndrome was significantly associated with a higher incidence of adverse outcomes (EF <40%) compared to patients with normal HbA1c levels (p<0.0001).
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