Comparison of Diagnostic Criteria to Detect Undiagnosed Diabetes in Acute Coronary Syndrome Patients with Admission Hyperglycemia

Authors

  • Mohammad Sarwar Alam Department of Cardiology, National Institute of Cardiovascular diseases, Dhaka
  • HI Lutfur Rahman Khan Department of Cardiology, Dhaka Medical College, Dhaka
  • Abdul Wadud Chowdhury Department of Cardiology, Dhaka Medical College, Dhaka
  • Khandker Md Nurus Sabah Department of Cardiology, Dhaka Medical College, Dhaka
  • Md Gaffar Amin Department of Cardiology, Dhaka Medical College, Dhaka
  • SM Eftar Jahan Kabir Department of Cardiology, National Institute of Cardiovascular diseases, Dhaka
  • Abu Sadique Abdullah Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka
  • Mofazzal Hossain Upazilla Health Complex, Basail, Tangail
  • Tunaggina Afrin Khan Department of Cardiology, Anowar khan Modern Medical College & Hospital, Dhaka
  • Md Sk Shahidullah Department of Microbiology, OSD, DGHS

DOI:

https://doi.org/10.3329/cardio.v8i1.24766

Keywords:

Acute Coronary Syndrome, Fasting blood sugar, Admission plasma sugar, Oral glucose tolerance test, Glycated haemoglobin, Coronary artery disease, Diabetes mellitus

Abstract

Background: Diabetes mellitus is one of the most important risk factors of coronary artery disease. Admission hyperglycemia adversely influences the outcome of acute coronary syndrome patients. The study was conducted to compare the various diagnostic methods for the detection of undiagnosed diabetes mellitus in acute coronary syndrome patients with admission hyperglycaemia in Bangladeshi population.

Methods: It was a cross sectional comparative study involving 157 patients with admission blood glucose level e7.8 mmol/l. Fasting plasma glucose, Glycated haemoglobin, pre-discharge oral glucose tolerance test was measured in all subjects and comparison of performance of different methods was done.

Results: Oral glucose tolerance test revealed that in spite of admission hyperglycaemia, 57 (36.3%) patients were diabetic and 52 (33.12%) patients had impaired glucose homeostasis and 48 (30.57%) patients had normal glucose metabolism. Undiagnosed diabetes could not be adequately predicted with admission plasma glucose, fasting plasma glucose or HbA1c alone (area under the ROC curve 0.589, 0.825 and 0.852 respectively).

Conclusion: Admission hyperglycaemia does not diagnose diabetes reliably in a stressful condition like acute coronary syndrome. Although neither admission plasma glucose, fasting plasma glucose, nor HbA1c level were as good as oral glucose tolerance test in detecting true diabetes, but combined fasting plasma glucose & HbA1c were found to be more sensitive & specific screening tool for detecting unknown diabetes in acute coronary syndrome patients with admission hyperglycaemia.

Cardiovasc. j. 2015; 8(1): 35-42

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Author Biography

Mohammad Sarwar Alam, Department of Cardiology, National Institute of Cardiovascular diseases, Dhaka



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Published

2015-08-28

How to Cite

Alam, M. S., Khan, H. L. R., Chowdhury, A. W., Sabah, K. M. N., Amin, M. G., Kabir, S. E. J., Abdullah, A. S., Hossain, M., Khan, T. A., & Shahidullah, M. S. (2015). Comparison of Diagnostic Criteria to Detect Undiagnosed Diabetes in Acute Coronary Syndrome Patients with Admission Hyperglycemia. Cardiovascular Journal, 8(1), 35–42. https://doi.org/10.3329/cardio.v8i1.24766

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Original Articles