Prognostic importance of admission versus persistent glycemia in acute coronary syndrome.

Abstract Background Whether persistent hyperglycemia (PG) during hospitalisation has a greater impact on adverse outcomes in acute myocardial infarction (AMI) than a single random glucose measurement is not well defined. Aims To find out the association of admission glycemia (AG) VS PG on outcomes in patients of ACS. Study design and methods Prospective, cohort, hospital-based. We evaluated 200 patients of ACS for admission and in-hospital glycemia and their impacts on outcomes. AG was defined as a plasma glucose >198 mg/dl and PG as a random glucose >140 mg/dl at any point during hospitalisation. Demographic and biochemistry including risk factors recorded. A multiple regression was done to evaluate association of various parameters with worse prognosis. Results Of the 200 patients evaluated, 35 (17.5%) presented with AG. 31 (15.5%) had PG. Males were predominant and 47 (23%) previously known diabetic patients. 62 (31%) had unstable angina, 52 (26%) NSTEMI and 86 (43%) STEMI, between PG and LEF, higher troponin levels and in-hospital mortality and between LEF and age ( p p 0.023) and mean in-hospital glucose ( p 0.005). F -indices were compared with AG for their ability to discriminate hospitalization survivors from non-survivors. All average glucose metrics performed better than AG. The ability of these models improved as the time window increased ( F -indices for admission, mean 24 h, 48 h and 72 h were 2.51, 12.05, 8.3 and 5.72, respectively). Conclusion The present study demonstrates that PG is a better discriminator of prognosis than AG in patients of ACS.