STUDY OF IMPACT OF GLYCOSYLATED HEMOGLOBIN ON ACUTE CARDIAC STATES

Abstract

Objectives: To find out the impact of HbA1c levels on the severity and short term complications of patients with heart disease admitted to the Intensive Care Unit (ICU) of Smt. Rasilaben Sevantilal Shah Hospital, Surat.

Methods: 100 patients admitted to ICU with acute cardiac states (STEMI, NSTEMI, UA, DCM, Acute LVF) were prospectively studied. Patients were divided into 2 groups – group A (Diabetics) and group B (Non-Diabetics) and patients were followed up till the time of discharge.

Results: Out of the 100 patients, 58 were Diabetic and 42 were Non Diabetic. The mean HbA1c of Diabetics was 8.9 ± 1.8% and that of Non-Diabetics was 6.03 ± 1.1%. Risk factors like dyslipidemia, hypertension, obesity, previous history of heart disease were found more in Diabetic group than in Non-Diabetic group. History of tobacco chewing, smoking, alcohol, positive family history of heart disease, were more in Non-Diabetic group. Complications like cardiogenic shock, accelerated hypertension, arrhythmias and re-infarction occurred significantly more in patients with patients with HbA1c > 7. Mortality is high in patients with HbA1C>7 (15.5%). STEMI, NSTEMI, UA were seen in a significantly higher proportion of patients with poor glycemic control (HbA1c > 7%) compared to patients with HbA1c level < 7%. In Non-Diabetics 39/42 (92.7%) Patients had HbA1c levels > 5%, 61.8% of whom had HbA1c levels of >5.6%.

Conclusion: Severity and complications of heart disease were significantly higher in diabetics and showed a significant correlation with HbA1c. A large number of nondiabetics presenting with acute cardiac states i.e. 92.7%, had HbA1c values > 5%.