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: Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Department of Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, Austin Health, Melbourne, Victoria; Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
Department of Pathology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Aug-2019
metadata.dc.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: http://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
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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