THE IMPACT OF HYPERGLYCAEMIA ON MORBIDITY AND MORTALITY OF ACUTE CORONARY SYNDROMES AND ACUTE MYOCARDIAL INFARCTION

Authors

  • Palwasha Sahibzada
  • Ambreen Ali Khan
  • Waheed A Sahibzada

Abstract

Background: Though diabetes and hyperglycaemia are well known risk factors for morbidity
and mortality associated with Coronary Heart Disease, there are no studies published from
Pakistan on the impact of non-diabetic hyperglycaemia on these indices. The present study
was undertaken to fill the gap in knowledge related to this aspect of hyperglycaemia in
Pakistani patients. Methods: We studied 166 patients admitted to our coronary care unit from
May 2008 to March 2009 with acute coronary syndrome and acute myocardial infarction. The
patients were divided into three groups (a) Diabetic group (b) Impaired glucose group and (c)
Normal glucose group according to the American Diabetic Association criteria. Results: It
was observed that with increasing level of hyperglycaemia there was an increase in the
mortality, with a p-value of 0.058. Hyperglycaemia was also associated with impaired left
ventricular function and clinical evidence of left ventricular failure. Insulin therapy was under
utilized and may have contributed to increased morbidity and mortality.
Keywords: Coronary artery syndromes, Myocardial infarction, Diabetes mellitus, Hyperglycaemia

References

Muclespacher D, Radovanovic D, Camerizind E,Essiq M,

Bertel O, Erne P, et al. Admission Glycemia and outcome in

patients with Acute Coronary Syndrome. Diabetes Vas Dis

Res 2007;4:346-52.

Wild S, Roglic G, Green A. Global Prevalence of Diabetes:

Estimates for the year 2000 and projections for

Diabetes Care 2004;27:1047-53.

Ghaffar A, Reddy S, Singhi M. Burden of non communicable

diseases in South Asia. BMJ 2004;328(7443):807-10.

Aamir AH. Targets for treating Type 2 diabetes and

preventing its complications: can we achieve it? Pak J Med

Res 2004;43(2):95-6.

Gasior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M,

Hawranek M et al. Effect of blood glucose levels on

prognosis in acute myocardial infarction in patients with and

J Ayub Med Coll Abbottabad 2009;21(1)

http://www.ayubmed.edu.pk/JAMC/PAST/21-1/Palwasha.pdf 115

without diabetes, undergoing percutaneous coronary

intervention. Cardiol J 2008;5(5):422-30.

Kosiborod M. Blood Glucose and its prognostic implications

in patients hospitalized with acute myocardial infarction.

Diabetes Vasc Dis Res 2008;5:269-75.

Health profile of the people of Pakistan National Health

Survey. Pakistan Medical Research Council, Islamabad

-94, ISBN 969-499-000-9.56.

Hassan ZS. Survival after myocardial infarction in patients

with type 2 diabetes J Pak Med Associ 2004;54(2):73-80.

Abid AR, Mallick NH, Shahbaz A, Tarin SMA. In-hospital

out come of acute myocardial infarction (ST segment

elevation type) in diabetics and non-diabetics. J Coll

Physicians Surg Pak 2005;15(9):524-7.

Khan AN, Ambreen F, Qureshi IZ. Hyperglycemia & in

hospital outcomes after first myocardial infarction. Rawal

Med J 2006;31(2):55-7.

Verges B, Zeller M, Dentan G, Beer JC, Laurent Y, JaninManificat L et al. Impact of fasting glycemia on short term

prognosis after acute myocardial infarction. J Clin

Endocrinol Metab 2007;92(6):2136-40.

Nordin C, Amir uddin R, Rucker L, Choi J, Kohli A, Marantz

PR. Diabetes and Stress Hyperglycemia Associated with

Myocardial Infarctions at an Urban Municipal Hospital,

Prevalence and effect on Mortality. Cardiol Rev

;13:223-30.

Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H

Cox JL. Is Blood Glucose An Independent Predictor of

Mortality in Acute Myocardial Infarction In the

Thrombolytic Era? J Am Coll Cardiol 2002;40:1748-54.

Ishihara M, Inoue I, Kawagoe T, Shimatiu Y, Kurisa S,

Nishioka K et al. Impact of acute hyperglycemia on left

ventricular function after reperfusion therapy in patients with

a first anterior wall acute myocardial infarction. Am Heart J

;146:674-8.

Bolk J, Ploeg TVD, Cornel JH, Arnold AER,Serpers J,

Umans VAWM et al. Impaired glucose metabolisim predicts

mortality after a myocardial infarction. Int J Cardiol

;79:207-14.

Sala J, Mabia R, Gonzalez de Molina J, Fernandez-Real JM,

Gil M, Bosch D, et al. Short term mortality of myocardial

infarction patients with diabetes or hyperglycemia during

admission J. Epidemiol. Community Health 2002;56:707-12.

Capes SE, Hunt D, Malmberg K, Gerstein HC, Stress

hyperglycemia and increased risk of death after myocardial

infarction in patients with and without diabetes: a systematic

overview. Lancet 2000;355:773-8.

Stranders I, Diamant M, E.vanGelder R, Spruijt HJ, Twisk

JWR, Heine RJ et al. Admission blood glucose level as risk

indicator of death after Myocardial Infarction in patients with

and without diabetes mellitus. Arch Intern Med

;164:982-8.

Published

2009-03-01

How to Cite

Sahibzada, P., Khan, A. A., & Sahibzada, W. A. (2009). THE IMPACT OF HYPERGLYCAEMIA ON MORBIDITY AND MORTALITY OF ACUTE CORONARY SYNDROMES AND ACUTE MYOCARDIAL INFARCTION. Journal of Ayub Medical College Abbottabad, 21(1), 110–115. Retrieved from https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/3795