Association between glycometabolic status in the acute phase and 21/2 years after an acute coronary syndrome.
OBJECTIVE
To evaluate the association between glycometabolic status in the acute phase and 21/2 years later in patients with acute coronary syndrome (ACS).


METHODS
Non-diabetic patients (n = 762) presenting with ACS were prospectively followed up for 21/2 years. Patients were stratified by admission plasma glucose (<6.1 mmol/l, 6.1 - 6.9 mmol/l and >or=7.0 mmol/l) and HbA1c (<or=4.5%, 4.6 - 5.4% and >or=5.5%). The predictive value of glucose levels >or= 7.0 mmol/l and HbA1c >or= 5.5% for glycometabolic disturbance (i.e. diabetes or impaired fasting glycaemia (IFG)) was analysed.


RESULTS
Of 762 patients, 13% had a diagnosis of diabetes and 16% had IFG at follow-up. The prevalence of glycometabolic disturbance at follow-up increased with increasing plasma glucose at admission, from 19% in patients with < 6.1 mmol/l to 42% in patients with >or= 7.0 mmol/l. Sixty-one percent of patients with HbA1c >or= 5.5% had glycometabolic disturbance after 21/2 years compared to only 25% of those with HbA1c < 5.5%.


CONCLUSIONS
Non-diabetic patients with ACS and hyperglycaemia are at high risk for developing glycometabolic disturbance. HbA1c may be an even stronger predictor of glycometabolic disturbance than plasma glucose.
Petursson
P
P
Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. petur.petursson@vgregion.se
Herlitz
J
J
Caidahl
K
K
From-Attebring
M
M
Sjöland
H
H
Gudbjörnsdottir
S
S
Hartford
M
M
D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000150:complications; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications; D011446:Prospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin