PREVALENCE OF UNDIAGNOSED DIABETES MELLITUS AMONG PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME (ACS)
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1013Keywords:
Acute Coronary Syndrome, Diabetes Mellitus, Hypertension, Prevalence, UndiagnosedAbstract
Acute Coronary Syndrome (ACS) represents a spectrum of cardiovascular conditions ranging from unstable angina to acute myocardial infarction, all of which require urgent medical attention. Objectives: The study's primary purpose is to find the prevalence of undiagnosed diabetes mellitus among patients presenting with acute coronary syndrome (ACS). Methods: This cross-sectional study was conducted in Khyber Teaching Hospital Peshawar from June 2021 to June 2022. Data was collected from 245 patients of ACS. Upon admission, demographic data, including age, gender, and medical history, were recorded. Laboratory investigations were performed to measure fasting blood glucose levels using standard techniques. Results: Data was collected from 245 ACS patients. The mean age of the patients was 48.7 ± 6.2 years. There were 170 male and 75 female patients. The prevalence of comorbidities was notable, with hypertension being the most common (49.0%), followed by dyslipidemia (40.8%), smoking (32.7%), and family history (24.5%). Serum creatinine levels were 1.2 ± 0.3 mg/dL, slightly elevated compared to the normal range of 0.6 - 1.1 mg/dL. Blood urea nitrogen levels averaged 20.5 ± 4.2 mg/dL, within the standard 7 - 20 mg/dL range. Fasting blood glucose levels were 120 ± 25 mg/dL, slightly above the normal range of 70 - 110 mg/dL. Hypertension was also associated with an increased risk of UDM, although not statistically significant, with an odds ratio of 1.8 (95% CI: 0.9 - 3.5). Conclusion: It is concluded that the prevalence of undiagnosed diabetes mellitus among patients presenting with acute coronary syndrome (ACS) is substantial, highlighting the importance of routine screening in this population. Early detection and management of diabetes in ACS patients are essential for optimizing cardiovascular outcomes and reducing the risk of adverse events.
Downloads
References
Zhou M, Liu J, Hao Y, Liu J, Huo Y, Smith SC Jr, Ge J, Ma C, Han Y, Fonarow GC, Taubert KA, Morgan L, Yang N, Xing Y, Zhao D; CCC-ACS Investigators. Prevalence and in-hospital outcomes of diabetes among patients with acute coronary syndrome in China: findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project. Cardiovasc Diabetol. 2018 Nov 27;17(1):147. doi: 10.1186/s12933-018-0793-x. PMID: 30482187; PMCID: PMC6258152.
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio ALP, Crea F, Goudevenos JA, Halvorsen S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with st-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) Eur Heart J. 2018;39(2):119–177. doi: 10.1093/eurheartj/ehx393.
Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, Bax JJ, Borger MA, Brotons C, Chew DP, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) Eur Heart J. 2016;37(3):267–315.
Luo M, Lim WY, Tan CS, Ning Y, Chia KS, van Dam RM, Tang WE, Tan NC, Chen R, Tai ES, et al. Longitudinal trends in HbA1c and associations with comorbidity and all-cause mortality in Asian patients with type 2 diabetes: a cohort study. Diabetes Res Clin Pract. 2017;133:69–77. doi: 10.1016/j.diabres.2017.08.013.
Issa M, Alqahtani F, Ziada KM, Stanazai Q, Aljohani S, Berzingi C, Giordano J, Alkhouli M. Incidence and outcomes of non-ST elevation myocardial infarction in patients hospitalized with decompensated diabetes. Am J Cardiol. 2018;122(8):1297–1302. doi: 10.1016/j.amjcard.2018.07.004.
Savonitto S, Morici N, Nozza A, Cosentino F, Perrone Filardi P, Murena E, Morocutti G, Ferri M, Cavallini C, Eijkemans MJ, et al. Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes. Diabetes Vasc Dis Res. 2018;15(1):14–23. doi: 10.1177/1479164117735493.
She J, Deng Y, Wu Y, Xia Y, Li H, Liang X, Shi R, Yuan Z. Hemoglobin A1c is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty. Cardiovasc Diabetol. 2017;16(1):97. doi: 10.1186/s12933-017-0578-7.
Hong TP, Mu YM, Ji LN, Guo XH, Zhu DL, Tong NW, Huo Y, Shen YP, Zhao D, Jiao K, et al. Chinese expert consensus on anti-diabetic agents in treating patients with type 2 diabetes and atherosclerotic cardiovascular disease. Chin J Diabetes. 2017;25(6):481–492.
de Miguel-Yanes JM, Jimenez-Garcia R, Hernandez-Barrera V, Mendez-Bailon M, de Miguel-Diez J, Lopez-de-Andres A. Impact of type 2 diabetes mellitus on in-hospital-mortality after major cardiovascular events in Spain (2002–2014) Cardiovasc Diabetol. 2017;16(1):126. doi: 10.1186/s12933-017-0609-4.
Jung CH, Chung JO, Han K, Ko SH, Ko KS, Park JY, Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes A Improved trends in cardiovascular complications among subjects with type 2 diabetes in Korea: a nationwide study (2006–2013) Cardiovasc Diabetol. 2017;16(1):1. doi: 10.1186/s12933-016-0482-6
Kumar N, Verma R, Chouhan B, Goyal P. Study of Prevalence of Undiagnosed Diabetes Mellitus in Patients Presenting with Acute Coronary Syndrome. J Assoc Physicians India. 2022 Apr;70(4):11-12. PMID: 35443392.
Karamat, M.A., Raja, U.Y., Manley, S.E. et al. Prevalence of undiagnosed type 2 diabetes in patients admitted with acute coronary syndrome: the utility of easily reproducible screening methods. BMC Endocr Disord 17, 3 (2017). https://doi.org/10.1186/s12902-017-0153-y
Dar, M. I., Beig, J. R., Jan, I., Shah, T. R., Ali, M., Rather, H. A., & Tramboo, N. A. (2020). Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome. The Egyptian Heart Journal, 72(1), 1-8.
Niedziela, J. T., Hiczkiewicz, J., Kleinrok, A., Pączek, P., Leszek, P., Lelonek, M., ... & Gąsior, M. (2020). Prevalence, characteristics, and prognostic implications of type 2 diabetes in patients with myocardial infarction: the Polish Registry of Acute Coronary Syndromes (PL ACS) annual 2018 report. Kardiologia Polska (Polish Heart Journal), 78(3), 243-246.
Bjarnason, T. A., Hafthorsson, S. O., Kristinsdottir, L. B., Oskarsdottir, E. S., Johnsen, A., & Andersen, K. (2020). The prognostic effect of known and newly detected type 2 diabetes in patients with acute coronary syndrome. European Heart Journal: Acute Cardiovascular Care, 9(6), 608-615.
Drobek, N., Sowa, P., Jankowski, P., Haberka, M., Gąsior, Z., Kosior, D., ... & Kamiński, K. (2021). Undiagnosed diabetes and prediabetes in patients with chronic coronary syndromes—An alarming public health issue. Journal of Clinical Medicine, 10(9), 1981.
Zhou, J., Liu, C., Zhou, P., Li, J., Chen, R., Wang, Y., ... & Yan, H. (2021). Prevalence and impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome. Nutrition, Metabolism and Cardiovascular Diseases, 31(9), 2693-2699.
Ali, U., Ashraf, A., & Ahmad, A. (2022). DIABETIC PATIENTS AND THEIR PRESENTATION IN ACUTE CORONARY SYNDROME WITH OUTCOMES: DOES GENDER PLAY ROLE?. Pakistan Heart Journal, 55(1), 79-82.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 . MAAZ, A BATOOL , M FAROOQ , ET BHATTY , M MEHTAB , F ASIM , M SARFRAZ, W AHMAD
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.