THE IMPACT OF HYPERGLYCAEMIA ON MORBIDITY AND MORTALITY OF ACUTE CORONARY SYNDROMES AND ACUTE MYOCARDIAL INFARCTION
Abstract
Background: Though diabetes and hyperglycaemia are well known risk factors for morbidityand mortality associated with Coronary Heart Disease, there are no studies published fromPakistan on the impact of non-diabetic hyperglycaemia on these indices. The present studywas undertaken to fill the gap in knowledge related to this aspect of hyperglycaemia inPakistani patients. Methods: We studied 166 patients admitted to our coronary care unit fromMay 2008 to March 2009 with acute coronary syndrome and acute myocardial infarction. Thepatients were divided into three groups (a) Diabetic group (b) Impaired glucose group and (c)Normal glucose group according to the American Diabetic Association criteria. Results: Itwas observed that with increasing level of hyperglycaemia there was an increase in themortality, with a p-value of 0.058. Hyperglycaemia was also associated with impaired leftventricular function and clinical evidence of left ventricular failure. Insulin therapy was underutilized and may have contributed to increased morbidity and mortality.Keywords: Coronary artery syndromes, Myocardial infarction, Diabetes mellitus, HyperglycaemiaReferences
Muclespacher D, Radovanovic D, Camerizind E,Essiq M,
Bertel O, Erne P, et al. Admission Glycemia and outcome in
patients with Acute Coronary Syndrome. Diabetes Vas Dis
Res 2007;4:346–52.
Wild S, Roglic G, Green A. Global Prevalence of Diabetes:
Estimates for the year 2000 and projections for
Diabetes Care 2004;27:1047–53.
Ghaffar A, Reddy S, Singhi M. Burden of non communicable
diseases in South Asia. BMJ 2004;328(7443):807–10.
Aamir AH. Targets for treating Type 2 diabetes and
preventing its complications: can we achieve it? Pak J Med
Res 2004;43(2):95–6.
Gasior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M,
Hawranek M et al. Effect of blood glucose levels on
prognosis in acute myocardial infarction in patients with and
J Ayub Med Coll Abbottabad 2009;21(1)
http://www.ayubmed.edu.pk/JAMC/PAST/21-1/Palwasha.pdf 115
without diabetes, undergoing percutaneous coronary
intervention. Cardiol J 2008;5(5):422–30.
Kosiborod M. Blood Glucose and its prognostic implications
in patients hospitalized with acute myocardial infarction.
Diabetes Vasc Dis Res 2008;5:269–75.
Health profile of the people of Pakistan National Health
Survey. Pakistan Medical Research Council, Islamabad
–94, ISBN 969-499-000-9.56.
Hassan ZS. Survival after myocardial infarction in patients
with type 2 diabetes J Pak Med Associ 2004;54(2):73–80.
Abid AR, Mallick NH, Shahbaz A, Tarin SMA. In-hospital
out come of acute myocardial infarction (ST segment
elevation type) in diabetics and non-diabetics. J Coll
Physicians Surg Pak 2005;15(9):524–7.
Khan AN, Ambreen F, Qureshi IZ. Hyperglycemia & in
hospital outcomes after first myocardial infarction. Rawal
Med J 2006;31(2):55–7.
Verges B, Zeller M, Dentan G, Beer JC, Laurent Y, JaninManificat L et al. Impact of fasting glycemia on short term
prognosis after acute myocardial infarction. J Clin
Endocrinol Metab 2007;92(6):2136–40.
Nordin C, Amir uddin R, Rucker L, Choi J, Kohli A, Marantz
PR. Diabetes and Stress Hyperglycemia Associated with
Myocardial Infarctions at an Urban Municipal Hospital,
Prevalence and effect on Mortality. Cardiol Rev
;13:223–30.
Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H
Cox JL. Is Blood Glucose An Independent Predictor of
Mortality in Acute Myocardial Infarction In the
Thrombolytic Era? J Am Coll Cardiol 2002;40:1748–54.
Ishihara M, Inoue I, Kawagoe T, Shimatiu Y, Kurisa S,
Nishioka K et al. Impact of acute hyperglycemia on left
ventricular function after reperfusion therapy in patients with
a first anterior wall acute myocardial infarction. Am Heart J
;146:674–8.
Bolk J, Ploeg TVD, Cornel JH, Arnold AER,Serpers J,
Umans VAWM et al. Impaired glucose metabolisim predicts
mortality after a myocardial infarction. Int J Cardiol
;79:207–14.
Sala J, Mabia R, Gonzalez de Molina J, Fernandez-Real JM,
Gil M, Bosch D, et al. Short term mortality of myocardial
infarction patients with diabetes or hyperglycemia during
admission J. Epidemiol. Community Health 2002;56:707–12.
Capes SE, Hunt D, Malmberg K, Gerstein HC, Stress
hyperglycemia and increased risk of death after myocardial
infarction in patients with and without diabetes: a systematic
overview. Lancet 2000;355:773–8.
Stranders I, Diamant M, E.vanGelder R, Spruijt HJ, Twisk
JWR, Heine RJ et al. Admission blood glucose level as risk
indicator of death after Myocardial Infarction in patients with
and without diabetes mellitus. Arch Intern Med
;164:982–8.
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