Newly Diagnosed Diabetes and Stress Glycaemia ...

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Sep 30, 2015 - diabetes and stress hyperglycemia. Stress hyperglycemia is defined by ADA (American Diabetes. Association) as an elevation of fasting ...
OA Maced J Med Sci electronic publication ahead of print, published on September 30, 2015 as http://dx.doi.org/10.3889/oamjms.2015.103

ID Design 2012/DOOEL Skopje Open Access Macedonian Journal of Medical Sciences. http://dx.doi.org/10.3889/oamjms.2015.103 eISSN: 1857-9655 Clinical Science

Newly Diagnosed Diabetes and Stress Glycaemia and Its’ Association with Acute Coronary Syndrome 1

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Gordana Kamceva , Marija Vavlukis , Darko Kitanoski , Sashko Kedev 1

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University "Goce Delchev", Faculty of Medical Sciences, Clinical Hospital Shtip, Shtip, Republic of Macedonia; Ss Cyril and Methodius University of Skopje, Faculty of Medicine, University Clinic for Cardiology, Skopje, Republic of Macedonia

Abstract Citation: Kamceva G, Vavlukis M, Kitanoski D, Kedev S. Newly Diagnosed Diabetes and Stress Glycaemia and Its’ Association with Acute Coronary Syndrome. OA Maced J Med Sci. http://dx.doi.org/10.3889/oamjms.2015.103 Key words: diabetes mellitus; stress glycaemya; hemoglobin A1C; acute coronary syndrome; cardiac events. *

Correspondence: Dr. Marija Vavlukis. UC of Cardiology, ICCU, Mother Theresa 17, Skopje 1000, Republic of Macedonia. Phone: 003892 3113116. Fax: 003892 3164134. E-Mail: [email protected] Received: 20-Sep-2015; Revised: 23-Sep-2015; Accepted: 24-Sep-2015; Online first: 30-Sep-2015 Copyright: © 2015 Gordana Kamceva, Marija Vavlukis, Darko Kitanoski, Sashko Kedev. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The authors have declared that no competing interests exist.

BACKGROUND: Diabetes is diagnosed in 10-20% of patients with acute coronary syndrome (ACS) not known to be diabetics. Elevated blood glucose is an independent risk factor for cardiac events, regardless of presence of diabetes. AIM: Evaluating the prevalence of new-diagnosed DM among patients with ACS, and assessing the relationship between stress glycaemia and new diagnosed DM with in-hospital cardiac events. METHODS: Prospective observational study, in patients with ACS, in whom we analyzed parameters of glycemic metabolism, clinical data, and in-hospital cardiac events. We comparatively analyzed patients according to the HgbA1C and known DM in five groups: non-DM (< 5.6%), new pre-DM (5.6-6.5%), new DM (≥ 6.5%), controlled (7 mmoll/L, or random plasma glucose (RPG) >11.1 mmol/L, or HgbA1C >6.5%), and HgbA1C >5.6% for the definition of pre-diabetes; for the definition of stress hyperglycemia: an elevation of FPG ≥7 mmol/L, or RPG ≥ 11 mmol/L in a patient without evidence of previous diabetes. We used glycosylated hemoglobin (HbA1c) value to distinguish between patients with stress hyperglycemia and those with previously undiagnosed diabetes (an HbA1c value ≥ 6.5% indicated pre-existing unrecognized diabetes, whereas HbA1c value < 6.5% indicated stressinduced hyperglycemia). Also, we used the ADA recommendations for controlled diabetes (HgbA1C