Prevalence of Glucose Intolerance in Non-Diabetic Patients with Acute Coronary Syndrome; Correlation with in Hospital Outcome

Abstract

Diabetes and coronary artery diseases often appear as the two sides of a coin: on one side, DM has been rated as an equivalent of CAD, and conversely, many patients with established CAD suffer from DM or its pre-state. Diabetes and prediabetes are painless and remain undetected if not investigated. Our study aimed at discovering the prevalence of prediabetes in patients admitted with acute coronary syndrome to the coronary care unit in National Heart Institute and their in-hospital outcome. We screened 200 patients mainly for their fasting plasma glucose, 2-hr OGTT and HbA1C. Other laboratory investigations were also noted as lipid profile and cardiac biomarkers. Echocardiography was done for all patients, 17.5% had ejection fraction below 40%. We found 20% of patients prediabetic, 24.5% had newly diagnosed diabetes and 55.5% had normal glucose regulation. In their follow-up patients with abnormal glucose regulation (prediabetes and newly diagnosed diabetics) had the worest outcome. 7.5% of patients suffered cardiac death. Epidemiologic evidence suggests that the complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes which is an important risk factor for hyperlipidemia and atherosclerosis and is commonly associated with hypertension, abnormalities of coagulation, platelet adhesion and aggregation. Early identification and treatment of persons with prediabetes have the potential to reduce or delay the progression to diabetes and related CVD and microvascular disease.