Association of Admission Blood Glucose Level with Major Adverse Cardiac Events in Acute Coronary Syndrome; a Cohort
Mostafa Alavi-Moghaddam1, Mohamad Parsa-Mahjoob2, Robabeh Ghodssi-Ghassemabadi3
1Emergency Medicine Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. mosalavi@sbmu.ac.ir.
Insights
Abnormal admission blood glucose levels in patients with suspected acute coronary syndrome are linked to a higher risk of major adverse cardiac events within 30 days. This highlights the importance of monitoring blood glucose in ACS patients.
Area of Science:
- Cardiology
- Endocrinology
- Emergency Medicine
Background:
- Managing abnormal admission blood glucose levels (ABGL) in acute coronary syndrome (ACS) patients is a clinical challenge.
- The impact of ABGL on short-term cardiac outcomes in ACS requires further investigation.
Purpose of the Study:
- To evaluate the association between ABGL and the development of 30-day major adverse cardiac events (MACE) in patients with suspected ACS.
Main Methods:
- A prospective cohort study involving patients admitted to the emergency department with suspected ACS.
- Measurement of ABGL and tracking of MACE (myocardial infarction, cerebrovascular accident, mortality) within 30 days post-admission.
Main Results:
- The study included 814 participants (mean age 61.8 years, 58.1% male).
- MACE occurred in 39.0% of hyperglycemic, 46.9% of hypoglycemic, and 16.4% of normoglycemic patients (p<0.001).
- Abnormal ABGL, elevated troponin levels, diabetes history, and ECG changes were independent predictors of 30-day MACE.
Conclusions:
- Abnormal admission blood glucose levels are an independent predictor of 30-day MACE in patients with suspected ACS.
- Monitoring and managing ABGL may be crucial for improving outcomes in ACS patients.
Introduction:
Appropriate management of abnormal admission blood glucose level (ABGL) in acute coronary syndrome (ACS) patients still remains a common issue. This study aims to assess the influence of ABGL on development of 30-day major adverse cardiac events (MACEs) in patients with suspected ACS.
Methods:
This is a prospective cohort study based on analysis of data collected from patients suspected to acute coronary syndrome admitted to emergency department. ABGL of patients was measured and its association with development of MACEs (MI, CVA, mortality) within 30 days of follow-up was studied.
Results:
814 participants with the mean age of 61.8 ± 13.4 years were studied (58.1% male). MACE endpoints were developed in 166 (39.0%) hyperglycemic, 30 (46.9%) hypoglycemic, and 53 (16.4%) normoglycemic patients (p<0.001). Mean admission blood glucose level of patients who developed MACE within 30 days was significantly higher than others (210.6 ± 123.4 vs 157.4 ± 86.6mg/dL; p<0.001; OR: 1.006 (1.005 to 1.008)). There was a significant correlation between male gender (p=0.027), abnormal admission blood glucose level (p<0.001), diabetes (p = 0.001), hyoerlipidemia (p=0.059), prior CABG (p=0.008), first and second blood troponin levels (p<0.001), first and second abnormal ECGs (p<0.001), and also ECG changes (p<0.001) with developing MACE. Abnormal ABGL, first and second blood troponin levels, and the history of diabetes were among independent risk factors of developing MACE within 30 days.
Conclusion:
It seems that abnormal admission blood glucose level in suspected ACS patients was an independent predictor of major adverse cardiac events within 30 days.
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