Abstract
Background and Objective:
Hyperglycemia on admission is associated with increased mortality and morbidity in
acute coronary syndrome (ACS) irrespective of presence of diabetes mellitus. To the
best of our knowledge, no evidence on the relationship between stress hyperglycemia
(SH) and the extent of coronary artery disease is found in the literature. Our objective
in this study is to assess the relationship of SH with the prognosis of acute coronary
syndrome, extent of coronary artery disease (CAD), development of arrhythmia, and
major adverse cardiac events.
Method:
89 patients who were hospitalized in the coronary intensive care unit with diagnosis
of ACS between January 2010 and June 2010 were enrolled in the study. The patients
were separated into 2 groups as having stress hyperglycemia or not, according to
their blood glucose levels on admission. TIMI and GRACE risk scores were obtained
and GENSINI scoring was performed to assess CAD extent for all the patients. Major
adverse cardiac events (MACE) (death, MI, re-revascularization, stroke) were recorded
for all patients while in the hospital and at 1st and 6th months.
Results:
In our study, MACE, GENSINI scores at 6 months and development of in-hospital arrhythmia
rates were statistically significantly higher and left ventricular ejection fractions
were statistically significantly lower in the group with SH. The association of TIMI,
GRACE, GENSINI, New York Heart Association (NYHA) and Killip classifications with
blood glucose, fasting blood glucose and HbA1c on admission was confirmed.
Conclusion:
Prognostic course happens to be worse and CAD is more extensive in patients with SH.
In addition, blood glucose values may have to be estimated lower compared to the samples
in the literature, in order to diagnose SH.
Key words
acute coronary syndromes - stress hyperglycemia - extent of coronary artery disease
