Prevalence of prediabetes in patients with acute coronary syndrome: impact on in-hospital outcomes.
Intern Med J. 2014 Dec 1;
Authors: AbuShady MM, Mohamady Y, Enany B, Nammas W
BACKGROUND: Prediabetes is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.
AIMS: We sought to explore the prevalence of prediabetes in patients admitted with acute coronary syndrome who were not known to have diabetes; and to determine the impact of prediabetes on in-hospital clinical outcomes versus non-diabetic patients.
METHODS: Prospectively, we enrolled 200 patients not known to have diabetes or prediabetes, admitted with acute coronary syndrome . Laboratory tests included fasting plasma glucose (FPG), 2-hour plasma glucose (2-hPG) after 75 g glucose, HbA1c and lipid profile. Electrocardiogram and echocardiography were done. The primary endpoint was in-hospital major adverse cardiovascular events (MACE).
RESULTS: Mean age was 50.9 ± 6.8 years (70.5% males). The prevalence of patients with diabetes and patients with prediabetes was 24.5% and 20% respectively. Newly discovered diabetic patients were excluded. Compared with patients without diabetes, prediabetic patients had a higher body mass index (BMI) (p=0.002), and a longer hospital stay (p=0.09). In-hospital MACE occurred in 10 (25%) patients with prediabetes versus 6 (5.4%) in patients without diabetes (p=0.001). In-hospital MACE correlated with prediabetes (r=0.28, p<0.001), BMI (r=0.14, p=0.093), FPG (r=0.19, p=0.014), 2-hPG (r=0.19, p=0.017), and HbA1c (r=0.19, p=0.019). Multivariate regression analysis identified prediabetes as the only independent predictor of in-hospital MACE.
CONCLUSIONS: Prediabetes is common in patients presenting with acute coronary syndrome who are not previously known to have diabetes. Prediabetic patients had worse in-hospital clinical outcomes compared with patients without diabetes.
PMID: 25443454 [PubMed - as supplied by publisher]