Blood Glucose on Admission and Prognosis in Non- Diabetic Acute Coronary Patients Treated with Percutaneous Interventions

Background-glycemic control in cardiac patients is necessary to improve mortality and morbidity; however, the impact of admission glycemic control in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) has not been extensively investigated. The aim of this study was to evaluate the association between the serum glucose level (BG) on admission and the rate of cumulative in-hospital and 6-month adverse events in non-diabetic ACS patients undergoing PCI. Methods-This case-series study analyzed 100 non-diabetic patients - with intermediate to high-risk unstable angina or non-ST elevation myocardial infarction - who were candidated for early PCI. BG was measured on admission and adverse events were recorded during the hospital course and up to six months. Results-The mean level of BG on admission was 147.70 ± 66.20 mg/dL (range = 72 to 382 mg/dL). Among the patients followed up, the rate of major adverse events (MACCE) was 6.0%. The mean BG on admission in the group with MACCE was significantly higher than that among patients without MACCE (192.50 ± 77.34 mg/dL vs. 144.84 ± 64.85 mg/dL; p value = 0.010). According to the ROC curve analysis, BG on admission had an acceptable value for predicting MACCE (c = 0.723, 95% CI: 0.601 – 0.844). The best cut-off point of BG for discriminating MACCE from non-MACCE status was 140 mg/dL with a sensitivity of 67.0% and a specificity of 73.0%. Considering this cut off value, 66.7% of the patients with MACCE and only 31.9% of the non-MACCE patients had glucose levels > 140 mg/dL (relative risk =4.267, 95% CI: 1.236 – 14.726). Conclusion-Measuring BG on admission can predict untoward events in patients with ACS treated with elective PCI.