A Study on Correlation of Random Blood Sugar Levels with Cardiovascular Outcome in Patients of Myocardial Infarction at a Tertiary Care Centre.

UNLABELLED

Myocardial infarction is the death of a portion of myocardium due to a prolonged ischaemia. Myocardial infarction is the leading cause of mortality around the globe. Mortality could be due to various complications of mi such as ventricular failure, cardiogenic shock and arrhythmias. With the rise in sedentary lifestyle and poor dietary habits, the incidence of diabetes is increasing too. Diabetes is an independent risk factor for coronary artery disease. Acute hyperglycemia is a response seen commonly during stressful conditions including myocardial infarction. Raised blood sugar levels could be due to diabetes or a marker of pre existing diabetes which is not yet diagnosed. Raised sugar levels increase oxidative stress, endothelial dysfunction and impair fibrinolysis thereby leading to adverse outcomes in patients of mi. Raised sugar levels could also indicate insulin resistance or beta cell failure which could have a detrimental impact in patients with mi via various other pathways. Random blood sugar is a relatively easy test to perform and can hence be used as marker of prognosis in mi patients.

MATERIAL

an observational study of 50 patients who were admitted in a tertiary care centre for myocardial infarction. All patients were closely monitored and all clinical manifestations, laboratory parameters and relevant scans were studied.

OBSERVATION

out of the total patients studied, 42% had stemi and 58% had n stemi, most patients belonged to age group between 40-80 years. From the total patients studied, adverse cardiovascular outcomes were seen more commonly in patients having on admission rbs readings above 200mg/dl and hba1c of greater than 8% the most common adverse outcome noted was heart failure with reduced ejection fraction. Second most common adverse outcome was arrhythmia of which most common was ventricular tachycardia. Adverse outcomes were more common in newly detected diabetics than patients who were a known case of diabetes having mi. Death was seen in 8% of cases, all having rbs readings ranging from 154 to 436 mg/dl.

CONCLUSION

myocardial infarction is the most common cause of mortality in the world. Hyperglycaemia and diabetes are independent risk factors for various life threatening complications of myocardial infarction. Hyperglycaemia causes endothelial dysfunction by increasing oxidative stress via multiple pathways. The likelihood of developing complications post myocardial infarction is higher with hyperglycaemia.