Newly Diagnosed Diabetes and Stress Glycaemia and Its' Association with Acute Coronary Syndrome.
BACKGROUND
Diabetes is diagnosed in 10-20% of patients with acute coronary syndrome (ACS) not known to be diabetics. Elevated blood glucose is an independent risk factor for cardiac events, regardless of presence of diabetes.


OBJECTIVE
Evaluating the prevalence of new-diagnosed DM among patients with ACS, and assessing the relationship between stress glycaemia and new diagnosed DM with in-hospital cardiac events.


METHODS
Prospective observational study, in patients with ACS, in whom we analyzed parameters of glycemic metabolism, clinical data, and in-hospital cardiac events. We comparatively analyzed patients according to the HgbA1C and known DM in five groups: non-DM (< 5.6%), new pre-DM (5.6-6.5%), new DM (≥ 6.5%), controlled (<7%) and uncontrolled (≥7%) known DM.


RESULTS
150 patients, (93 male and 57 female) were included. Impaired glucose metabolism was detected in 44.5% of patients, 7.9% of whom were newly-diagnosed DM. The highest levels of stress glycaemia were found in new and uncontrolled known DM. The in-hospital event rate was 20.7%, the mortality rate 7.3%, being the highest in new diagnosed and uncontrolled known DM patients.


CONCLUSIONS
The prevalence of unknown DM was high among patients with ACS. Stress glycaemia and failure to achieve glycemic controlee, were an independent predictors of in-hospital cardiac events.
University "Goce Delchev", Faculty of Medical Sciences, Clinical Hospital Shtip, Shtip, Republic of Macedonia.
Gordana
G
Kamceva
Ss Cyril and Methodius University of Skopje, Faculty of Medicine, University Clinic for Cardiology, Skopje, Republic of Macedonia.
Marija
M
Vavlukis
Ss Cyril and Methodius University of Skopje, Faculty of Medicine, University Clinic for Cardiology, Skopje, Republic of Macedonia.
Darko
D
Kitanoski
Ss Cyril and Methodius University of Skopje, Faculty of Medicine, University Clinic for Cardiology, Skopje, Republic of Macedonia.
Sashko
S
Kedev
acute coronary syndrome; cardiac events; diabetes mellitus; hemoglobin A1C; stress glycaemya