title: Cardiac damage associated with stress hyperglycaemia and acute coronary syndrome changes according to level of presenting blood glucose.
abstract: OBJECTIVE
  To determine the prevalence of stress hyperglycaemia in people presenting with acute coronary syndrome (ACS), and the relationships between admission glucose and cardiac damage, cardiovascular mortality and morbidity.
  
  
  METHODS
  In a prospective observational study people presenting with ACS at the Gold Coast Hospital had their admission glucose (AG) level tested to determine stress hyperglycaemia. A range of measurements supplemented this data including troponin levels, category of ACS and major adverse coronary events (MACEs) were obtained through hospital records and patient follow-up post-discharge.
  
  
  RESULTS
  One hundred eighty-eight participants were recruited. The prevalence of stress hyperglycaemia in ACS was 44% with 31% having a previous diagnosis of type 2 diabetes and 7.7% had undiagnosed diabetes. The stress hyperglycaemic group had a significantly higher median troponin levels compared to participants with normal blood glucose levels on admission (p<0.05) however the highest presenting glucose group (>15 mmol/L) had troponin levels similar to people presenting with normal blood glucose levels and ACS (p>0.05).
  
  
  CONCLUSIONS
  Cardiac necrosis as measured by troponin levels is significantly increased in people with ACS and stress hyperglycaemia. This study found that one in four participants presenting with ACS and an admission glucose of >7.0 had no previous diagnosis for diabetes.
  
  
  CONCLUSIONS
  Consistently ordering HbA1C testing on patients with high AG can enable earlier diagnosis and treatment of diabetes.
authors.affiliation: Cardiology Department, Gold Coast University Hospital, Parkwood, Queensland, Australia; School of Medical Sciences, Griffith University, Southport, Queensland, Australia.
authors.forename: Talib
authors.initials: T
authors.lastname: Al Jumaily
authors.affiliation: School of Medical Sciences, Griffith University, Southport, Queensland, Australia. Electronic address: r.rosemeyer@griffith.edu.au.
authors.forename: Roselyn B
authors.initials: RB
authors.lastname: Rose'Meyer
authors.affiliation: Cardiology Department, Gold Coast University Hospital, Parkwood, Queensland, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Sweeny
authors.affiliation: Cardiology Department, Gold Coast University Hospital, Parkwood, Queensland, Australia; School of Medicine, Griffith University, Southport, Queensland, Australia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Jayasinghe
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D015415:Biomarkers; D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013312:Stress, Physiological / Q000502:physiology*; D014336:Troponin / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D014336:Troponin
keywords: Acute coronary syndrome; Diabetes mellitus; HbA1c-glycocylated haemoglobin; Major acute cardiac events; Troponin