title: Prevalence of prediabetes in patients with acute coronary syndrome: impact on in-hospital outcomes.
abstract: BACKGROUND
  Prediabetes is a serious condition that is associated with an increase in cardiovascular morbidity and mortality.
  
  
  OBJECTIVE
  We sought to explore the prevalence of prediabetes in patients admitted with acute coronary syndrome (ACS) who were not known to have diabetes and to determine the impact of prediabetes on in-hospital clinical outcomes versus non-diabetic patients.
  
  
  METHODS
  Prospectively, we enrolled 200 patients not known to have diabetes or prediabetes, admitted with ACS. Laboratory tests included fasting plasma glucose (FPG), 2-h plasma glucose (2hPG) after 75 g glucose, HbA1c and lipid profile. Electrocardiogram and echocardiography were done. The primary end-point was in-hospital major adverse cardiovascular events (MACE).
  
  
  RESULTS
  Mean age was 50.9 ± 6.8 years (70.5% males). The prevalence of patients with diabetes and patients with prediabetes was 24.5% and 20% respectively. Newly discovered diabetic patients were excluded. Compared with patients without diabetes, prediabetic patients had a higher body mass index (BMI) (P = 0.002) and a longer hospital stay (P = 0.09). In-hospital MACE occurred in 10 (25%) patients with prediabetes versus six (5.4%) in patients without diabetes (P = 0.001). In-hospital MACE correlated with prediabetes (r = 0.28, P < 0.001), BMI (r = 0.14, P = 0.093), FPG (r = 0.19, P = 0.014), 2hPG (r = 0.19, P = 0.017) and HbA1c (r = 0.19, P = 0.019). Multivariate regression analysis identified prediabetes as the only independent predictor of in-hospital MACE.
  
  
  CONCLUSIONS
  Prediabetes is common in patients presenting with ACS who are not previously known to have diabetes. Prediabetic patients had worse in-hospital clinical outcomes compared with patients without diabetes.
authors.affiliation: Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: M M
authors.initials: MM
authors.lastname: AbuShady
authors.forename: Y
authors.initials: Y
authors.lastname: Mohamady
authors.forename: B
authors.initials: B
authors.lastname: Enany
authors.forename: W
authors.initials: W
authors.lastname: Nammas
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: acute coronary syndrome; major adverse cardiovascular event; outcome; prediabetes; prevalence