Abhijeet A Nashte^1*, Ravindra K Shravasti², Amey S Vaidya³

^1,3Junior resident, ²Professor, Department of General Medicine Bharati Vidyapeeth Deemed to be University Medical College and Hospital, Sangli, Maharashtra, INDIA.

Email: abhiraj.nashte@gmail.com

RESULTS

Table 1: Distribution of patients according to the sex

Table 2: Distribution of patients according to the age

Table 5: Distribution of patients according to the blood sugar and HbA1c

Table 7: Distribution of patients according to the ECG findings

Table 10: Distribution of patients according to the complications

Table 11: Association of complications with glycosylated hemoglobin and blood sugar levels

DISCUSSION

Nonmodifiable factors that influence risk for coronary artery disease include age and sex. Men have a higher risk than women thus in this study most of the patients were males (54%) and male to female ratio was 1.17:1.14 Most of the patients were (37%) aged between 61 to 70 years and 32% of the patients were aged between 51 to 60 years. The mean age was 62.36±9.89 years. Chest pain has been reported as the cardinal feature in patients with AMI. The WHO requires the presence of chest pain as one of the cornerstone feature for the diagnosis of chest pain15 and All the patients presented with chest pain radiating to left arm /radiating to back (100%). The next common complaint was breathlessness (57%) and vomiting and profuse sweating (45%). Fasting blood sugar levels were between 100 to 125 mg/dL in majority of the patients while ≥126 mg/dL were note in 11% of the patients. The mean fasting blood sugar levels were 107.64±10.60 mg/dL Post prandial blood sugar levels were noted as ≥140 mg/dL in majority of the patients. The mean post prandial blood sugar levels were 174.62±31.88 mg/dL. HbA1c levels were ≥6.5 percent in majority of the patients (68%). The mean HbA1c levels were 6.62±0.73 percent. Based on ECG, majority of the patients were diagnosed with STEMI (85%), followed by NSTEMI (14%). Complications were noted in 25% of the patients. LVF was the common complication noted in 16% of the patients and arrhythmia was noted in 5% of the patients while arrhythmia with LVF was noted in 4% of the patients Majority of the patients (98%) improved and discharged. While mortality was noted in 2% of the patients Significantly higher number of patients with HbA1c levels ≥6.5 percent developed complications (30.88% vs 12.50%; p=0.048) and elevated HbA1c level was a strong and independent predictor of severity and complication in ACS patients even in nondiabetics16

CONCLUSION

Overall, the present study showed that, elevated glycated haemoglobin at admission is associated not only with short term complications but also with adverse outcome. These findings require further validation due to the potential limitations of the study outcome. Hence further multicentric studies involving large sample size and long term follow up may provide the predictive role of admission glycated hemoglobin.

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