Dar Mohd Iqbal, Beig Jahangir Rashid, Jan Iqra, Shah Tariq Rashid, Ali Muzaffar, Rather Hilal A, Tramboo Nisar A
Department of Cardiology, SKIMS Soura, Srinagar, Jammu and Kashmir, 190011, India.
Department of Immunology and Molecular Medicine, SKIMS Soura, Srinagar, Jammu and Kashmir, 190011, India.
Egypt Heart J. 2020 Sep 29;72(1):66. doi: 10.1186/s43044-020-00101-0.
Acute coronary syndrome (ACS) indicates the serious clinical manifestation of coronary artery disease (CAD) and is closely associated with cardiovascular prognosis in patients with ACS. This study was aimed to study the prevalence of type 2 diabetes mellitus (T2DM) and the relation of HbA1c with the severity of CAD in patients presenting as non-diabetic ACS. Diabetic status of the patients was assessed with fasting blood sugar (FBS) and HbA1c levels, and coronary artery disease burden was assessed by coronary angiography.
Out of 208 patients, 85.1% were males, and 14.9% were females; 73.56% cases were hypertensive. 80.77% of cases had STEMI, 17.79% had NSTEMI, and 1.44% had unstable angina. Out of 168 STEMI patients, 64.3% were thrombolysed, 21.42% presented late, 2.38% had contraindications to thrombolysis, and 11.9% underwent primary PCI. FBS in diabetic range was found in 44.23% of cases, impaired FBS in 36.54%, and 19.23% of patients had FBS in non-diabetic range. According to HbA1c, 41.8% were diabetic, 39.4% were pre-diabetic, and 18.8% were non-diabetic. A significant positive correlation was found between HbA1c and Gensini score and between HbA1c and the number of vessels involved.
This study emphasises the importance of evaluating the presence of diabetes in patients presenting as non-diabetic acute coronary syndrome in developing countries. Acute coronary syndrome may be considered as one of the presentations of diabetes mellitus.
急性冠状动脉综合征（ACS）是冠状动脉疾病（CAD）的严重临床表现，与ACS患者的心血管预后密切相关。本研究旨在探讨非糖尿病ACS患者中2型糖尿病（T2DM）的患病率以及糖化血红蛋白（HbA1c）与CAD严重程度的关系。通过空腹血糖（FBS）和HbA1c水平评估患者的糖尿病状态，通过冠状动脉造影评估冠状动脉疾病负担。
208例患者中，男性占85.1%，女性占14.9%；73.56%的病例患有高血压。80.77%的病例为ST段抬高型心肌梗死（STEMI），17.79%为非ST段抬高型心肌梗死（NSTEMI），1.44%为不稳定型心绞痛。在168例STEMI患者中，64.3%接受了溶栓治疗，21.42%就诊延迟，2.38%有溶栓禁忌证，11.9%接受了直接经皮冠状动脉介入治疗（PCI）。44.23%的病例FBS处于糖尿病范围，36.54%的病例FBS受损，19.23%的患者FBS处于非糖尿病范围。根据HbA1c，41.8%为糖尿病患者，39.4%为糖尿病前期患者，18.8%为非糖尿病患者。HbA1c与Gensini评分之间以及HbA1c与受累血管数量之间存在显著正相关。
本研究强调了在发展中国家对非糖尿病急性冠状动脉综合征患者进行糖尿病评估的重要性。急性冠状动脉综合征可被视为糖尿病的表现之一。
