Predictive value of blood glucose as an independent risk factor for progression/ mortality in acute coronary syndrome

ABSTRACT

This study was designed to assess the prognostic significance of hyperglycemia in Acute Coronary Syndromes. Most studies that have examined this fact before were performed in patient with Acute Myocardial Infarction. [4, 18]. There were 320 patients admitted in M.U.III, Allied Hospital, Faisalabad between July 2006 and December 2006. Patients were divided according to history of Diabetes Mellitus and further according to whether they had blood glucose more than 198 mg/dl. Other cardiac risk factors, medications and interventions were analyzed and multivariate logistic regression was used to determine the influence of blood glucose on progression/ Mortality. About 122 patients were lost in follow up and 198 patients were followed for 2 months. In patients without history of diabetes, glucose levels were 198mg/dl in 136 patients [Group 1] and > 198 mg/dl in 24 patients [Group 2]. Of those with diabetes glucose levels were patients [Group 3] and > 198 mg/dl in 27 patients [Group 4]. Compare with Group 1 patients, the odds ratios [95% confidence interval] for in hospital progression/mortality among those in Group 2, 3 and 4 were 2.64 [1.32 to 4.52; p = .001], 1.63 [98 to 3.52; p = .035], and 1.88 [1.29 to 3.45; p = .012], respectively. These groups also have greater 2 months progression/mortality. Hyperglycemia in ACS is associated with worse prognosis in patients without diabetes. This finding signifies the underlying need for aggressive glucose management in these situations and perhaps more vigorous screening strategy for early recognition of diabetes. diagnosis of diabetes, was an independent predictor of in-hospital and 2 month morbidity and mortality. [9,24,36]. Setting and Study Population Allied Hospital, Punjab Medical College is a tertiary care hospital with 1500 beds and all state of the art modern facilities. Implications of elevated blood glucose were studies in 300 patient admitted to M.U. III during July