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Category: Volume 08 Issue 04 April 2020
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Title: Study of Glycosylated hemoglobin level in non-diabetic patients with acute coronary syndrome

Authors: Dr Kunal Ostwal, Dr Govind Shiddapur, Dr Sumit Khupse, Dr Varun Tiwari, Dr Narendran Sairam, Dr Asmita Samal

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.67

Abstract

   

Background: Diabetes is a major causative risk factor for the development of ACS & the adverse outcome after ACS. ‘Stress hyperglycaemia’ has been defined in different ways by various studies. Transient hyperglycaemia has been recognized as a noticeable feature in ACS and is related to stress (Lakhdar et al., 1984).[1] Glycosylated haemoglobin is thus useful to differentiate between stress hyperglycaemia diabetes mellitus. Glycosylated haemoglobin has more sensitivity and specificity for diagnosing diabetes in acute myocardial infarction patients, than admission hyperglycaemia.

Methods: All the patients presenting with Acute coronary syndrome and with no previous history of diabetes admitted in Department of General Medicine during the study period from September 2017 to August 2019 were included in the study.

Results: Among 100 patients, males were predominant (70%). 38% patients were in the age group of 51-60 years of age (max). Most common presenting complaint of patients was chest pain (84%) followed by dyspnoea (17%), lower limbedema (16%), and palpitations (9%). 58 % patients had HbA1c > 7 % which was considered as raised 42 % had HbA1c within normal limits. 58 % patients had previously unrecognized diabetes mellitus that came to light after HbA1c estimation. This would have been otherwise interpreted as stress hyperglycaemia. Thus, HbA1c estimation permits prompt and precise identification of previously undiagnosed diabetes mellitus.

Conclusion: HbA1c estimation is a useful, simple, easy and quick method for early and quick method for accurate measurement and interpretation of hyperglycaemia following acute myocardial infarction

Keywords: Acute coronary syndrome, HbA1c, Non diabetics.

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Corresponding Author

Dr Kunal Ostwal

Department of General Medicine Dr. D. Y. Patil Medical College, hospital and research centre, Pimpri, Pune