Prevalence of Unrecognized Diabetes Mellitus in Patients Admitted With Acute Coronary Syndrome

Abdullatef, Waleed K.; Al-Aqeedi, Rafid Fayadh; Dabdoob, Wafer; Hajar, H.A.; Bener, Abdülbari; Gehani, A. A.

doi:10.1177/0003319711434054

Cited by 16 publications

(13 citation statements)

References 22 publications

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“…Finding accurate indicators which can be used to determine the prognosis of these patients emerges as a target of interest. In our study, we analyzed the general conditions and comorbidities in DM and non-DM patients, and the ratio of DM in the observed Chinese ACS octogenarians was over one third, which was higher than the prior reports by about 20-30% [33,34]. The Cys C level was significantly different, while severity of coronary artery (Genesis score), GRACE risk score as well as general renal function indicators were not significantly different between DM and non-DM patients.…”

Section: Discussionmentioning

confidence: 77%

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Xue

Guo

et al. 2013

Cardiovasc Diabetol

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ObjectiveCystatin C (Cys C) is a marker of renal dysfunction. Prior studies have shown that blood Cys C is related to the prognosis of coronary heart disease. The aim of the present study was to evaluate the long-term prognostic impact of Cys C on acute coronary syndrome (ACS) octogenarians with diabetes mellitus (DM).MethodsWe enrolled 660 consecutive ACS octogenarians who underwent coronary angiography and were classified into two groups based on diabetes. The baseline characters and Cys C level were measured on admission. Survival curve was calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify predictors of mortality and of major adverse cardiac events (MACE) rate.ResultsThere were 223 and 398 patients in groups DM and non-DM who fulfilled the follow-up. The average follow-up period was 28 (IQR 16–38) months. Diastolic blood pressure (DBP) was lower, ratios of hypertension and chronic renal failure (CRF), fasting blood glucose, HbA1c and Cys C levels were higher in DM group than those in non-DM group (P<0.01). The cumulative survival of DM group was significantly lower than that of non-DM group in the long term (P = 0.018). All cause mortality and MACE of DM group were higher than those of non-DM group (P<0.05). The plasma Cys C concentration (OR = 3.32, 95% CI = 1.18-10.92, P = 0.023) was the uniqueness independent predictor for long-term all cause mortality. The plasma Cys C concentration (OR = 2.47, 95% CI = 1.07-7.86, P = 0.029) and Genesis score (OR = 1.01, 95% CI = 1.00-1.03, P = 0.043) were independent predictors for MACE in DM group. ROC curve analysis showed that the predictive cut-off value of Cys C for mortality of DM group was 1.605 (0.718, 0.704).ConclusionsCys C is an independent predictor for long-term mortality and MACE of ACS octogenarians with DM.

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Section: Discussionmentioning

confidence: 77%

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Xue

Guo

et al. 2013

Cardiovasc Diabetol

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“…Prevalence of glucose abnormalities among patients with no previous history of diabetes presenting with ACS in previous studies vary between 21% -84% (8,9). A study conducted in urban India revealed that 84% of patients with ACS with no previous history of diabetes have abnormalities in glucose metabolism based on the findings of OGTT (10).…”

Section: Discussionmentioning

confidence: 99%

Value of testing glycated hemoglobin in non-diabetic patients presenting with acute coronary syndrome

Nanayakkara

Weerarathna

Herath

et al. 2015

Sri Lanka J. Diabetes Endocrinol. Metab.

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“…However, a recent study from the Middle East had demonstrated similar incidence of stress hyperglycemia and unrecognized diabetes in ACS patients with no prior diagnosis of diabetes. [17]…”

Section: Discussionmentioning

confidence: 99%

High incidence of abnormal glucose metabolism in acute coronary syndrome patients at a moderate altitude: A sub-Himalayan study

Mokta¹,

Kumar²,

Ganju³

et al. 2017

Indian J Endocr Metab

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Background:Abnormal glucose metabolic status at admission is an important marker of future cardiovascular events and long-term mortality after acute coronary syndrome (ACS), whether or not they are known diabetics.Objective:The aims were to study the prevalence of abnormal glucose metabolism in ACS patients and to compare the different methods of diagnosing diabetes in ACS patients.Methods:We did a prospective study. About 250 consecutive nondiabetic patients (200 men and 50 women) with ACS admitted to a tertiary care institute of Himachal Pradesh in 1 year were enrolled. Admission plasma glucose, next morning fasting plasma glucose (FPG), A1C, and a standardized 75-g oral glucose tolerance test (OGTT) 72 h after admission were done. Glucose metabolism was categorized as normal glucose metabolism, impaired glucose metabolism (impaired fasting glucose or impaired glucose tolerance [IGT]), and diabetes. Diabetes was arbitrarily classified further as undiagnosed (HBA1c ≥6.5%) or possibly stress diabetes (HBA1c <6.5%). A repeat OGTT after 3 months in objects with IGT and stress hyperglycemia at a time of admission was done.Results:The mean age was 54 ± 12.46 years. The mean plasma glucose at admission was 124 ± 53.96 mg/dL, and the mean FPG was 102 ± 27.07 mg/dL. The mean 2-h postglucose load concentration was 159.5 ± 56.58 mg/dL. At baseline, 95 (38%) had normal glucose metabolism, 95 (38%) had impaired glucose metabolism (IGT and or IGT) and 60 (24%) had diabetes; 48 (19.2%) were undiagnosed diabetes and 12 (4.8%) had stress hyperglycemia. At follow up 58.66% and 55.55% of patients with impaired glucose tolerance and stress hyperglycemia continued to have impaired glucose tolerance respectively. About 75 gm OGTT has highest sensitivity and specificity to diagnose diabetes, whereas A1C most specific to rule out stress hyperglycemia.Conclusions:In this small hilly state of India, abnormal glucose metabolism (previously undiagnosed diabetes and IGT) is common in patients admitted with ACS. Abnormal glucometabolic status can be detected early in the postadmission period. Our results further suggest that 75-g OGTT remained the gold standard test to detect diabetes and could be used before discharge to diagnose diabetes.

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Prevalence of Unrecognized Diabetes Mellitus in Patients Admitted With Acute Coronary Syndrome

Cited by 16 publications

References 22 publications

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Value of testing glycated hemoglobin in non-diabetic patients presenting with acute coronary syndrome

High incidence of abnormal glucose metabolism in acute coronary syndrome patients at a moderate altitude: A sub-Himalayan study

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