Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/21497
Title: Prevalence of pre-existing dysglycaemia among inpatients with acute coronary syndrome and associations with outcomes.
Austin Authors: Mahendran, Dinesh C;Hamilton, Garry;Weiss, Jeremy ;Churilov, Leonid ;Lew, Jeremy F ;Khoo, Kaylyn;Lam, Que T ;Robbins, Raymond J ;Hart, Graeme K ;Johnson, Douglas;Hare, David L ;Farouque, Omar ;Zajac, Jeffrey D ;Ekinci, Elif I 
Affiliation: Endocrinology
Cardiology
Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
Intensive Care
The Florey Institute of Neuroscience and Mental Health
Pathology
Medicine (University of Melbourne)
General Medicine
Issue Date: Aug-2019
Date: 2019-07-04
Publication information: Diabetes Research and Clinical Practice 2019; 154: 130-137
Abstract: We aimed to confirm the hypothesis that dysglycaemia including in the pre-diabetes range affects a majority of patients admitted with acute coronary syndrome (ACS) and is associated with worse outcomes. In this prospective observational cohort study, consecutive inpatients aged ≥ 54 years with ACS were uniformly tested and categorised into diabetes (prior diagnosis/ HbA1c ≥ 6.5%, ≥48 mmol/mol), pre-diabetes (HbA1c 5.7-6.4%, 39-47 mmol/mol) and no diabetes (HbA1c ≤ 5.6%, ≤38 mmol/mol) groups. Over two years, 847 consecutive inpatients presented with ACS. 313 (37%) inpatients had diabetes, 312 (37%) had pre-diabetes and 222 (25%) had no diabetes. Diabetes, compared with no diabetes, was associated with higher odds of acute pulmonary oedema (APO, odds ratio, OR 2.60, p < 0.01), longer length of stay (LOS, incidence rate ratio, IRR 1.18, p = 0.02) and, 12-month ACS recurrence (OR 1.86, p = 0.046) after adjustment, while no significant associations were identified for pre-diabetes. Analysed as a continuous variable, every 1% (11 mmol/mol) increase in HbA1c was associated with increased odds of APO (OR 1.28, P = 0.002) and a longer LOS (IRR 1.05, P = 0.03). The high prevalence of dysglycaemia and association with poorer clinical outcomes justifies routine HbA1c testing to identify individuals who may benefit from cardioprotective anti-hyperglycaemic agents and, lifestyle modification to prevent progression of pre-diabetes.
URI: https://ahro.austin.org.au/austinjspui/handle/1/21497
DOI: 10.1016/j.diabres.2019.07.002
ORCID: 0000-0003-2372-395X
0000-0003-3933-5708
0000-0001-9554-6556
Journal: Diabetes Research and Clinical Practice
PubMed URL: 31279958
Type: Journal Article
Subjects: Cardiovascular
Diabetes
Heart failure
Myocardial infarction
Pre-diabetes
Unstable angina
Appears in Collections:Journal articles

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