ADMISSION BLOOD GLUCOSE LEVEL AS A PREDICTOR OF IN-HOSPITAL MAJOR ADVERSE CARDIOVASCULAR EVENTS IN NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME

Abstract

Background: Acute coronary syndrome (ACS) remains a major cause of morbidity and mortality worldwide. Despite advances in reperfusion strategies and pharmacotherapy, a significant number of patients develop in-hospital major adverse cardiovascular events (MACE). Admission hyperglycemia has emerged as a potential prognostic marker even in patients without known diabetes mellitus. The present study evaluated the role of admission blood glucose in predicting in-hospital MACE among non-diabetic ACS patients.Methods: This prospective observational study was conducted in the Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India. Eighty-two non-diabetic adults admitted with ACS were enrolled. Patients with known diabetes or HbA1c ≥5.7% were excluded. Admission random blood sugar (RBS) was measured, and patients were categorized into normoglycemic (<140 mg/dL) and hyperglycemic (≥140 mg/dL) groups. Patients were followed during hospitalization for development of MACE, including cardiogenic shock, arrhythmias, heart failure, reinfarction, and cardiac arrest. Statistical analysis was performed using SPSS.Results: The mean age group most affected was 51–70 years (54.88%), and males constituted 73.2% of cases. Hyperglycemia was present in 50% of patients. Significant associations were observed between admission hyperglycemia and cardiogenic shock (85.7% vs. 14.3%, p=0.001), arrhythmias (76.5% vs. 23.5%, p=0.014), cardiac arrest (88.8% vs. 11.1%, p=0.029), and pulmonary edema (85.2% vs. 14.8%, p=0.001). No significant association was seen with heart failure, myocardial reinfarction or duration of hospital stay.Conclusion: Admission hyperglycemia is a strong predictor of adverse in-hospital cardiovascular outcomes in non-diabetic ACS patients. Routine glucose assessment at admission may aid in early risk stratification and identification of high-risk patients requiring closer monitoring and aggressive management.