In Hospital Outcome in First Attack of Acute Coronary Syndrome and Association of Glycated Haemoglobin A1c Level
First attack of ACS and HbA1c
Keywords:Acute coronary syndrome, HbA1c, Atherosclerosis, Obesity
Background: Diabetes where glycated Hemoglobin A1c (HbA1c) level is raised, a strong independent risk factor for the development of atherosclerosis which leads to acute coronary syndrome (ACS). This study is designed to compare the in-hospital outcomes in terms of developing arrhythmias, heart failure, cardiogenic shock, cardiac arrest and death among the normal HbA1c level (<6.5%) and raised HbA1c level (≥6.5%) patients who presented with ACS.
Objective: To compare the in-hospital outcomes of patients with raised HbA1c level (≥6.5%)and normal HbA1c level (<6.5%) after first attack of acute coronary syndrome.
Methods: A total of 104 patients admitted during the study period to coronary care unit (CCU) of Combined Military Hospital (CMH), Dhaka through emergency department or chest pain unit, who suffered from acute coronary syndrome were included in this study. Patients were divided into two groups, those having HbA1c ≥6.5% and <6.5%. Patients were followed up till discharge to observe their outcome in the hospital.
Results: A total of 104 patients were included in the study where 85(81.7%) were male and 19(18.3%) were female. Gender distribution were matched in both HbA1c level (p>0.05). Risk factors including hypertension, smoking and dyslipidaemia were found significantly high among those who had HbA1c ≥6.5 (p<0.05). There was no relation with family history of CAD with higher HbA1c level. Obesity was distributed evenly in both higher and lower HbA1c levels of the diagnosis of ACS 8(7.7%) were UA, 33(31.7%) were NSTEMI and 63(60.6%) were STEMI. There were less complications among the patients who had HbA1c <6.5% (p<0.05). Arrhythmias were found to be more common in HbA1c ≥6.5% group than HbA1c <6.5% group was (p<0.05), heart failure was more in HbA1c ≥6.5% group, 10(19.2%) and (p<0.05), cardiogenic shock was found more commonly in HbA1c ≥6.5% group, 6(11.5%) (p<0.05), cardiac arrest was more 10(19.2%) among HbA1c ≥6.5% group.
Finally, death was more in HbA1c ≥6.5% group. 10(19.2%) than the HbA1c <6.5% group and it was statistically significant (p<0.05).
Conclusion: Findings of the study suggest that higher HbA1c (≥6.5%) level is associated with more adverse in-hospital outcome among ACS patients.
Bangladesh Med Res Counc Bull 2021; 47(3): 260-265
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Copyright (c) 2022 Mohammad Nizamul Hossain Sowdagar, AFM Shamsul Haque, AKM Monwarul Islam, Zahida Jabbar, Syeda Aleya Sultana, Mohammad Kamar Uzzaman Sabery Khan
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