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Introduction Our objective was to determine the severity frequency of coronary artery disease (CAD) in prediabetes patients undergoing coronary angiography (CAG) in a catheterization laboratory. Materials and methods This descriptive comparative study was conducted on patients who were planned for elective CAG in the hospital from January 2019 to November 2019. The study includes patients age ≥40 years undergoing elective CAG with or without percutaneous coronary intervention/percutaneous transluminal coronary angioplasty. There were 458 patients (381 men and 77 women) in this study that were categorized into three groups on the basis on their glycated hemoglobin (HbA1c) levels: group I (n = 143) as non-diabetes, group II (n = 110) as prediabetes, and group III (n = 205) as diabetes. The severity of CAD was determined using the Gensini score. Results A total of 458 patients were included. Of these, 44.97% had hypertension; n = 36 (25.17%), n = 48 (43.63%), and n = 122 (59.51%) in group I, group II and group III, respectively (P = .0001). A total of 214 (46.72%) had a smoking history. There was a strong family history of CAD in group II (n = 29, 26.36%) and group III (n = 43, 20.98%). Group II and group III patients had a higher extension of CAD than group I (P = .01). Group II (n = 27, 41.54) and group III (n = 65, 50.39%) had a higher frequency of deployment of two stents compared to group I. Conclusion Coronary artery atherosclerosis disease increases parallel to the HbA1c severity and smoking. The present study emphasizes prediabetes as an independent risk factor for CAD.
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Background Type 2 diabetes mellitus (T2DM) is associated with acute coronary syndrome, and elevated blood glucose levels on hospital admission may influence outcomes in patients with ST-elevated myocardial infarction (STEMI). We conducted this study to determine the prognostic outcome of hyperglycemia at admission on in-hospital outcomes of STEMI patients with and without T2DM. Methods This prospective study was conducted from June 13, 2018, to October 12, 2019, and included patients older than 18 years diagnosed with STEMI. For our purposes, hyperglycemia was defined as blood glucose levels >140 mg/dl. Hypertension was considered as systolic blood pressure >140 mmHg or diastolic pressure > 90 mmHg. The predictive value of glycemia on admission for outcomes was assessed via patient mortality following thrombolysis or percutaneous coronary intervention (PCI). Results Our study included 256 patients (196 men, 76.5%; 60 women, 23.5%) with a mean age of 55 ± 11 years. A total of 92 patients (35.9%) were admitted with known T2DM diagnoses: 72 of them had hyperglycemia and 20 patients had euglycemia (p = 0.0001). Post-PCI mortality was six (18.8%) in the hyperglycemic group and one (2.2%) in the euglycemic group (p = 0.03). In-hospital mortality was higher in the hyperglycemic group (n = 12, 12.5%) compared to the euglycemic group (n = 6, 3.7%; p = 0.015). Significant risk factors of mortality for STEMI patients with hyperglycemia on admission were age 60 years or older (odds ratio [OR], 5.63 [1.54-20.58]; p = 0.007), heart failure on admission (OR, 6.84 [1.85-25.22)]; p = 0.003), T2DM (OR, 4.14 [0.50-33.96]; p = 0.05), and presenting with renal failure (OR, 6.78 [1.74-26.42]; p = 0.009). Conclusion Thrombolysis and PCI are effective and safe treatments in STEMI patients. Hyperglycemia has a great adverse impact on hospital outcomes in patients with or without T2DM. STEMI patients with hyperglycemia on hospital admission have higher mortality rates.
