title: Clinical significance of hyperglycaemia in acute coronary syndrome patients.
abstract: BACKGROUND
  The clinical significance of moment measurements (admission and fasting glycaemia), persistent (hyperglycaemic index, HGI; time average glucose, TAG; mean glucose; maximum glucose) or chronic hyperglycaemia (HbA1c), estimated average glucose, eAG) is still elusive in clinical practice.
  
  
  OBJECTIVE
  To identify the clinical significance of hyperglycaemia in ACS.
  
  
  METHODS
  The study included 226 consecutive patients with ACS. Indicators for hyperglycaemia were defined, calculated and a correlation analysis with standard parameters-EF, maximum CPK, maximum CPK-MB and troponin was performed. Patients were followed up for 12 months.
  
  
  RESULTS
  Indicators for persistent and chronic hyperglycaemia correlated neither to ejection fraction, nor to the enzymes for myocardial necrosis (P > 0.05). In contrast, acute hyperglycaemia correlated negatively with ventricular systolic dysfunction (P = 0.001/0.007) and positively with maximum CPK, MB and troponin (P = 0.0001/0.008). TAG was an independent predictor for 6-month re-hospitalization (P = 0.027) because of cardiac complications.
  
  
  CONCLUSIONS
  Glycaemia at admission and fasting glucose could be used as metabolic surrogate markers for ventricular systolic dysfunction and TAG as an independent surrogate marker for six-month re-hospitalization. None of the indicators for hyperglycaemia could be used as independent prognostic factors for survival. Hyperglycaemia rather reflects an underlying impairment in glucose metabolism.
authors: University Hospital 'Aleksandrovska', Clinic of Cardiology, Sofia, Bulgaria. jenicherneva@yahoo.com
authors: Zheyna Vlaeva
authors: ZV
authors: Cherneva
authors: Stefan Veselinov
authors: SV
authors: Denchev
authors: Mariana Vasileva
authors: MV
authors: Gospodinova
authors: Nora Petrova
authors: NP
authors: Milcheva
authors: Mariana Genova
authors: MG
authors: Petrova
authors: Radostina Vlaeva
authors: RV
authors: Cherneva
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications* / Q000401:mortality; D001786:Blood Glucose / Q000378:metabolism; D002031:Bulgaria; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D014336:Troponin / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D014336:Troponin; C517652:hemoglobin A1c protein, human