Role of Glycosylated Haemoglobin (HbA1c) in Predicting Acute Coronary Syndrome: a Retrospective Study

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Abstract (English)

Abstract
Aim: To investigate the predictive significance of glycosylated haemoglobin (HbA1C) in acute coronary
syndrome among the population of Bihar.
Material and Methods: This hospital-based retrospective study was conducted in the at Department of Medicine,
JNKTMCH, Madhepura, Bihar, India for one year. A total of 100 patients who presented with Acute Coronary
Syndrome (ACS) were enrolled in this study. Patients were selected based on their presentation with ACS
symptoms such as chest pain and were evaluated upon admission.
Results: The mean age was 62.36±9.89 years. All the patients presented with chest pain radiating to left arm
/radiating to back (100%). The next common complaint was breathlessness (57%) and vomiting and profuse
sweating (45%). Hypertension, tobacco/Misri chewing and smoking were the risk factors noted in 62%, 18% and
17% of the patients respectively. Fasting blood sugar levels were between 100 to 125 mg/dL in majority of the
patients while ≥126 mg/dL were note in 11% of the patients. The mean fasting blood sugar levels were
107.64±10.60 mg/dl.Post prandial blood sugar levels were noted as ≥140 mg/dL in majority of the patients. The
mean post prandial blood sugar levels were 174.62±31.88 mg/Dl HbA1c levels were ≥6.5 percent in majority of
the patients (68%).The mean HbA1c levels were 6.62±0.73 percent. Troponin I levels were raised among 99% of
the patients. Based on ECG, majority of the patients were diagnosed with STEMI (85%), followed by NSTEMI
(14%). Based on the 2D echocardiography most of the patients had anterior wall LW HK. Majority of the patients
were diagnosed with double vessel disease while single vessel disease was noted in 16% of the patients.
Conclusion: Based on the above results it may be concluded that, admission glycated haemoglobin levels are
associated with in hospital adverse events as well as outcome while outcome and adverse events were independent
of blood sugar levels that is, random, fasting and post prandial blood sugar levels hence, blood sugar levels have
limited prognostic value in patient with ACS.