EFFECT OF GLYCEMIC CONTROL ON ACUTE CORONARY SYNDROME PRESENTATION AMONG NON-DIABETIC PATIENTS, UNDERGONE CORONARY ARTERY ANGIOGRAPHY

Abstract

Impact of the combination of high admission glucose (AG) and glycated hemoglobin (HbA1c) levels in predicting clinical outcome of acute coronary syndrome (ACS) remains lesser known in nondiabetics. We aimed at studying the association the high levels of the combination of AG and HbA1c with the clinical presentations in nondiabetic patients with ACS. The aimed was to evaluate the impact of the combination of high AG and HbA1c levels on the severity and complications of ACS in nondiabetic patients. This observational cross-sectional study included 58 patients without diabetes mellitus who were admitted to the coronary care unit with symptoms suggestive of ACS. Diagnosis of ACS was confirmed by performing coronary angiography. Patients were classified according to their ABG & HbA1c into two groups: Group 1 with lower levels of both AG and HbA1c (< 120 mg/dL for ABG and <5.6% for HbA1c) and Group 2 with higher admission levels of both components (120-180 mg/dL for ABG and 5.7% - 6.4% for HbA1c). Main outcome measures were ECG changes, troponin T value, regional wall motion abnormalities and left ventricular ejection fraction on echocardiography, along with the complications such as heart failure and arrhythmias. Data were analyzed separately using multiple regression analysis. The mean age of patients was 58.5±11.6 years, out of which 77.6% were males and 22.4% females. Peak Troponin T values and the prevalence of STEMI were higher and left ventricular ejection fraction (LVEF) was lower in Groups 2 than in Group 1. The prevalence of congestive cardiac failure (CCF) and arrhythmias were higher in Groups 2. High admission glucose (AG) and HbA1c are a predictor of major adverse outcomes in nondiabetics with ACS. Measurement of HbA1c levels may improve risk assessment in such patients when presenting with ACS.