Impact of admission glycaemia on the annual risk of major cardiovascular events and development of type 2 diabetes mellitus in patients with non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention.

Elevated admission glycaemia (ABG) in a patient with or without type 2 diabetes (T2DM) is associated with adverse consequences. There is still a lack of accurate data on the adverse effects of ABG on the risk of major cardiovascular events and the development of T2DM in patients hospitalized for unstable angina (UA) or non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention. AIM: The main aim of this study was to evaluate the effect of ABG to the risk of major cardiovascular events and the development of T2DM during one year follow-up in patients with UA and NSTEMI. MATERIALS AND METHODS: 100 consecutive patients (68% men, mean age 64.2+/-10.5 years) hospitalized due to non-ST-elevation acute coronary syndrome (NSTE-ACS) were included in observational study. In each patient, medical history was taken and physical examination, standard diagnostics procedures, including venous glucose deterioration and coronarography were performed. Patients were assigned to two groups: UA or NSTEMI and observed during hospitalization and one year after discharge. RESULTS: 74 patients were diagnosed with NSTEMI and 26 with UA. 41 patients were treated for T2DM and 28 were diagnosed with impaired fasting glucose (IFG) prior to hospitalization. Both carbohydrate disorders occurred with a similar frequency in the compared groups of patients, and its incidence was comparable in both groups. During observation, T2DM was diagnosed only in 8 patients with IFG. Out of the 8 patients whose ABG was >250mg/dl, 7 died during one year, including three during hospitalization, and two during the first month after discharge. These patients were diagnosed with T2DM before hospitalization. CONCLUSIONS: Different degrees of impaired glucose homeostasis are present before or develop after occurrence NSTE-ACS. ABG >250mg/ dl in this group of patients is associated with the highest risk of death, regardless of the diagnosis of UA or NSTEMI.