Category: Lipids/CV Health

Monitor: 12

12 - BLOOD GLUCOSE LEVELS AND HBA1C AT ADMISSION:ASSOCIATION WITH COMPLICATIONS AND OUTCOME IN ACUTE MYOCARDIAL INFARCTION

Saturday, Apr 27
10:00 AM – 10:30 AM

Objective :

Hyperglycemia is often seen in patients with acute myocardial infarction and is a result of stress response due to high levels of catecholamines, cortisol and cytokines. Hyperglycemia may have a detrimental effect on ischaemic myocardium in the form of electrophysiological alteration, impaired left ventricular function and pump failure. This study was planned to find an association between admission blood glucose level and HbA1C with complications and outcome in patients with myocardial infarction.


Methods :

Hospital based observational, analytic and comparative study on 100 patients < 80 years of age presenting with acute myocardial infarction. Informed consent was taken from those fulfilling the inclusion criteria. Subjects were divided in two groups- Group 1 had 50 patients with blood sugar level < 180mg/dl and group 2 had 50 patients with level >180mg/dl. The patients were treated and assessed continuously for any complications like arrhythmia, heart failure, shock and death. Findings were analysed and correlated.


Results :

Both groups were age, sex ratio and mean BMI matched. Statistically significant difference was found in the mean HbA1c level which was 5.82 in group 1 and 7.015 in group 2. Statistically significant difference was also observed in the heart rate, systolic and diastolic blood pressure. Heart failure was seen in 8% patients in group 1 and 36% in group 2. Heart failure, left ventricular dysfunction and arrhythmias were also common in group 2 (23.1%).


Discussion : cardiac outcome has been associated with gycemic control with dreaded complications in poorly controlled patients.In both groups age, sex ratio and mean BMI were matched. Statistically significant difference was found in the mean HbA1c level which was 5.82% in group 1 and 7.02% in group 2 (p val <0.05). Statistically significant difference was also observed in the heart rate, systolic and diastolic blood pressure. Heart failure was seen in 8% patients in group 1 and 36% in group 2. Composite incidence of heart failure, left ventricular dysfunction and arrhythmias were also more common in group 2 (23.1%). In both groups, all lipid parameters were similar, without any significant difference.


Conclusion :

 Elevated blood glucose level represents an increased stress response and is common in acute myocardial infarction patients and is a powerful predictor of adverse outcome.  

SHORT URL FUNCTION-->

Shrikant Sharma

Associate Professor Internal medicine
SMS Medical College Jaipur Rajasthan India
Jaipur, Rajasthan, India

Serving the masses in cost effective treatment. Make the patient smile

Shrikant Sharma

Associate Professor Internal medicine
SMS Medical College Jaipur Rajasthan India
Jaipur, Rajasthan, India

Serving the masses in cost effective treatment. Make the patient smile

prakash keshwani

anu rajpurohit

kunal jhaveri

Senior Medical Advisor
Zydus Healthcare Limited
Mumbai, Maharashtra, India