A Study of Glycosylated Haemoglobin (HbA1C) in Acute Coronary Syndrome.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 4
Abstract
Introduction The World Health Organization (WHO) defines Diabetes Mellitus (DM) as: “a metabolic disorder of multiple aetiology characterized by chronichyperglycaemiawithdisturbancesofcarbohydrate,fatandprotein metabolism resulting from defects in insulin secretion, insulin action, or both(1). It is a complex disorder. Genetic and environmental factors play a major part in the pathogenesis of DM. Insulin resistance (IR) and pancreatic beta cell dysfunction are said to be the mechanism behind DM(2). Glycosylated Haemoglobin (HbA1c) is a biomarker reflecting both fasting and post prandial plasma glucose concentration over preceding 3months and also it has been regarded as an important tool in management of diabetes. HbA1c can be used to diagnose diabetes and the diagnosis can be made if HbA1c level is>6.5%. HbA1c between 5.8 to 6.5% indicates prediabetes.(3)The HbA1c is recommended as a standard of care (SOC) for testing and monitoring DM(4). The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with myocardial ischemia and covers the spectrum of clinical conditions ranging from unstable angina (UA), ST segment elevated myocardial infarction (STEMI) and non ST segment elevated myocardial infarction (NSTEMI).The main difference among these conditions is based on the underlying severity of the disease and resulting myocardial damage. Compared to non-diabetics, persons having diabetes have a two to four fold increased risk of death from CAD. In acute coronary syndrome, stress hyperglycaemia commonly occurs secondary to increased catecholamine levels. Due to stress hyperglycaemia, a method looking only at plasma glucose levels at the time of ACS cannot be used to predict the prognosis (5). Coronary Artery Disease (CAD) has emerged as the single most important cause of death worldwide and as well as in India. In 2013 CAD caused an estimated 7.5 million deaths accounting for 13.3% deaths worldwide (6). Epidemiological evidence now suggests HbA1c levels to be an independent risk factor for cardiovascular events (7). Present study was undertaken to find out the relationship of HbA1c and in-hospital outcome of ACS. Aims And Objectives Aim: To find out relationship of HbA1c with outcome of Acute Coronary Syndrome.
Authors and Affiliations
Dr. R. K. Jha
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