Frequency of Recently Poor Glycemic Control as Assessed by Hba1c in Diabetics Presented with Acute Coronary Syndrome

2021 ◽  
Vol 15 (11) ◽  
pp. 3072-3073
Author(s):  
Muhammad Ijaz Bhatti ◽  
Mehak Razzaq ◽  
Nasir Iqbal ◽  
Hassan Abbas Abdullah ◽  
Rajia Liaqat ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Significant Proportion ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Coronary Events

Aim: To find the frequency of recently poor glycemic control as assessed by HbA1c in diabetic patients with acute coronary syndrome Study design & Setting: Observational study. Methods: The study included 60 diabetic patients presented with acute coronary syndrome. Diagnosis of acute coronary syndrome was based on patient’s symptoms, ECG changes and cardiac enzyme results. HBA1c level report was collected for all patients from their hospital record. SPSS 21 version was used to analyze the collected data. The qualitative data was presented in the form of graphs while the quantitative data was presented by simple descriptive statistics in the form of mean, range and standard deviation. Results: Out of sixty patients enrolled in this study 2(45%) were females and 33(55%) were males. 28(46.67%) patients presented with ST-elevation MI (STEMI) whereas 25(41.66%) patients presented with non ST-elevation MI. 7(11.66%) had unstable angina. Out of sixty patients 21(35%) patients were having poor glycemic control (HBA1C >7%) whereas 39(65%) patients had fair glycemic control (HBA1C< 7%). Fifty eight (96%) patients were using oral anti diabetic tablets whereas 2(3.33%) patients were using insulin before hospital admission. Conclusion: This study shows that amongst patients admitted with acute coronary syndrome a significant proportion of patients (35%) had poor glycemic control over past three months as assessed by HBA1C implying that recent poor glycemic control is a significant risk factor for acute coronary events in diabetic patients. Keywords: Acute coronary syndrome, Glycemic control, Diabetes mellitus.

Assessment of and physician response to glycemic control in diabetic patients presenting with an acute coronary syndrome

2006 ◽  
Vol 152 (6) ◽  
pp. 1022-1027 ◽  
Author(s):  
Darcy L. Green Conaway ◽  
Jonathan R. Enriquez ◽  
Jaime E. Barberena ◽  
Philip G. Jones ◽  
James H. O'Keefe ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Physician Response

scholarly journals Prognostic relations between inflammatory markers and mortality in diabetic patients with non-ST elevation acute coronary syndrome

Heart ◽  
2004 ◽  
Vol 90 (3) ◽  
pp. 264-269 ◽  
Author(s):  
P L Sanchez ◽  
J L Morinigo ◽  
P Pabon ◽  
F Martin ◽  
I Piedra ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Leucocyte Count ◽  
Cardiovascular Death ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Inflammatory Status ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome

Objective: To determine the differences in the inflammatory status between diabetic and non-diabetic patients and to evaluate the usefulness of C reactive protein, fibrinogen, and leucocyte count as predictors of death in diabetic patients with unstable coronary disease.Design: Nested case-control comparisons of the inflammatory status between diabetic and non-diabetic patients. Prospective cohort analysis of C reactive protein concentration, fibrinogen concentration, and leucocyte count as predictors of cardiovascular death in diabetic patients.Setting: Coronary care unit in Spain.Participants: 83 diabetic patients with non-ST elevation acute coronary syndrome and 83 sex and aged matched patients selected from 361 non-diabetic patients with non-ST elevation acute coronary syndrome.Main outcome measures: Plasma concentrations of C reactive protein and fibrinogen, and leucocyte count. Investigators contacted patients to assess clinical events.Results: Concentrations of C reactive protein and fibrinogen, and leucocyte count on admission were higher in diabetic than in non-diabetic patients (7 mg/l v 5 mg/l, p  =  0.020; 3.34 g/l v 2.90 g/l, p  =  0.013; and 8.8 × 109/l v 7.8 × 109/l, p  =  0.040). Among diabetic patients, these values were also higher in those who died during the 22 month follow up (13 mg/l v 6 mg/l, p  =  0.001; 3.95 g/l v 3.05 g/l, p < 0.001; and 11.4 × 109/l v 8.4 × 109/l, p  =  0.005). After adjustment for confounding factors, diabetic patients in the highest tertile of C reactive protein had a hazard ratio for cardiovascular death of 4.51 (95% confidence interval (CI) 1.62 to 12.55). Similar hazard ratios were for fibrinogen 3.74 (95% CI 1.32 to 10.62) and for leucocyte count 3.64 (95% CI 1.37 to 9.68).Conclusions: Inflammation appears more evident in diabetic than in non-diabetic patients with acute coronary syndrome. C reactive protein concentration, fibrinogen concentration, and leucocyte count constitute independent predictors of cardiovascular death in diabetics with unstable coronary disease.

scholarly journals The Strategy of Management Patients with non-ST Elevation Acute Coronary Syndrome

Kardiologiia ◽  
2019 ◽  
Vol 59 (9) ◽  
pp. 40-51
Author(s):  
Yu. A. Prilutskaya ◽  
L. I. Dvoretski
Keyword(s):  
Acute Coronary Syndrome ◽  
Treatment Outcomes ◽  
Treatment Strategy ◽  
Management Strategy ◽  
Factors Affecting ◽  
Invasive Strategy ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Coronary Events

The review covers issues of epidemiology, diagnostics, management strategy, and treatment outcomes in patients with non-ST elevation acute coronary syndrome. Numerous factors affecting the choice of an invasive strategy are analyzed as well as its correspondence to existing recommendations of patient’s management. The stratification of risk of development of adverse coronary events, which is a part of the formation of a treatment strategy, is discussed.

scholarly journals Features of laboratory-diagnostic indicators in patients of different age groups with ST-elevation acute coronary syndrome

2019 ◽  
Vol 26 (1) ◽  
pp. 31-39 ◽  
Author(s):  
O. M. Parkhomenko ◽  
Ya. M. Lutay ◽  
D. O. Bilyi ◽  
O. I. Irkin ◽  
A. O. Stepura ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Familial Hypercholesterolemia ◽  
Age Groups ◽  
Young Patients ◽  
Significant Risk ◽  
Young Age ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome ◽  
Observation Period

The aim – to find out the features of laboratory diagnostic indicators in patients of different age groups with ST-elevation acute coronary syndrome. Materials and methods. Were analyzed the data of 835 patients admitted to the emergency departments from January 2000 to December 2015, with ST-elevation acute coronary syndrome. Patients were divided into the two groups depending on age: I group – patients <45 years of age (n=189), II group ≥ 45 years (n=646). Results and discussion. In young patients, hemoglobin and platelet levels were significantly higher throughout the observation period. Initial ALT and AST were significantly higher in young patients on day 1 (p<0.001 and p<0.01, respectively), but didn’t differ further. Baseline glucose level in patients <45 years of age was significantly lower than in the older group (p<0.05). Patients <45 years had higher values of fibrinogen (p=0.048). Young adults had lower total cholesterol, LDL at baseline (p<0.05) and the day 7 (p<0.001). Patients of 1 group showed higher HDL-C and TG (p<0.05). Probable FH was more common in the patients <45 years (7.34 and 1.32 %, p<0.05), in spite of lower HDL (3.47±0.12 and 3.83±0.08 mmol/l, p<0.05). Conclusions. The most significant risk factors for a MI at a young age are dyslipidemia and increased TG even in the absence of hypercholesterolemia. When allocating the group of familial hypercholesterolemia in patients with myocardial infarction at a yo≤ung age, familial hypercholesterolemia is observed significantly more often. The development of MI at a young age is often accompanied by an increase in the level of fibrinogen, hemoglobin and platelets, which may have a prothrombogenic effect.

scholarly journals Role of Tight Glycemic Control during Acute Coronary Syndrome on CV Outcome in Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ferdinando Carlo Sasso ◽  
Luca Rinaldi ◽  
Nadia Lascar ◽  
Aldo Marrone ◽  
Pia Clara Pafundi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Molecular Mechanisms ◽  
Tight Glycemic Control ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Hexosamine Pathway ◽  
Incidence And Mortality

Both incidence and mortality of acute coronary syndrome (ACS) among diabetic patients are much higher than those among nondiabetics. Actually, there are many studies that addressed glycemic control and CV risk, whilst the literature on the role of tight glycemic control during ACS is currently poor. Therefore, in this review, we critically discussed the studies that investigated this specific topic. Hyperglycemia is implicated in vascular damage and cardiac myocyte death through different molecular mechanisms as advanced glycation end products, protein kinase C, polyol pathway flux, and the hexosamine pathway. Moreover, high FFA concentrations may be toxic in acute ischemic myocardium due to several mechanisms, thus leading to endothelial dysfunction. A reduction in free fatty acid plasma levels and an increased availability of glucose can be achieved by using a glucose-insulin-potassium infusion (GIKi) during AMI. The GIKi is associated with an improvement of either long-term prognosis or left ventricular mechanical performance. DIGAMI studies suggested blood glucose level as a significant and independent mortality predictor among diabetic patients with recent ACS, enhancing the important role of glucose control in their management. Several mechanisms supporting the protective role of tight glycemic control during ACS, as well as position statements of Scientific Societies, were highlighted.

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