title: Impact of HbAlc on acute cardiac states.
abstract: OBJECTIVE
  To find out the impact of HbAlc levels on the severity and short term complications of patients with heart disease admitted to the Intensive Coronary Care Unit (ICCU).
  
  
  METHODS
  One hundred and sixty six patients admitted to ICCU in 2006 with acute cardiac states (unstable angina, acute myocardial infarction, heart failure, cardiomyopathy) were prospectively studied. Patients were divided into two groups--Group A (diabetics) and Group B (non diabetics). Patients were followed up till the time of discharge.
  
  
  RESULTS
  Out of the 166 patients, 92 were diabetic (group A) and 74 were non diabetic (group B). The mean HbAlc of group A was 8.4+1.9% and that of group B was 5.7+0.6%. Risk factors like dyslipidemia, hypertension, previous history of heart disease and triple vessel disease were found more in group A than in group B. History of smoking, positive family history of heart disease, and angina as a presenting symptom were more in group B. Complications like heart failure and post infarction angina occurred significantly more in patients with diabetes. In group A, unstable angina, ST elevation myocardial infarction, cardiac failure, accelerated hypertension, dilated cardiomyopathy and triple vessel disease were seen in a significantly higher proportion of patients with poor glycemic control (HbAlc>or=7%) compared to patients with HbAlc level<7%. In group B, 72/74 (97.2%) patients had HbAlc levels>or=5%, 68.8% of whom had HbAlc levels of >or=5.6%.
  
  
  CONCLUSIONS
  Severity and complications of heart disease were significantly higher in diabetics and showed a significant correlation with HbAlc. A large number of non diabetics presenting with acute cardiac states i.e. 97.2%, had HbAlc values>or=5%.
authors.affiliation: Department of Medicine, Christian Medical College and Hospital, Ludhiana-141008, Punjab.
authors.forename: Vinita Elizabeth
authors.initials: VE
authors.lastname: Mani
authors.forename: Mary
authors.initials: M
authors.lastname: John
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Calton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003325:Coronary Care Units; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006331:Heart Diseases / Q000097:blood* / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D006442:Glycated Hemoglobin