Glycemic Control of Diabetes Mellitus (DM) in Acute Coronary Syndrome (ACS) Patient

Abstract

Introduction: Diabetes mellitus (DM) is a predictor of recurrent ischaemic events in patients with the acute coronary syndrome (ACS) whilst cardiovascular disease remains the leading cause of mortality among patients with diabetes. This study aims to determine the prevalence of DM, glycemic control and predictors of poor glycemic control patients diagnosed with ACS in our population. Methods: This is a single centre, cross-sectional study of ACS patients admitted to cardiology wards, Hospital Serdang. A chi-square test was used to test the association between the prescribing pattern of antihyperglycemic agents and the glycemic control of DM patients. Logistic regression analysis was performed to determine the predictors of poorly glycemic controlled among DM patients with ACS. Results: A total of 486 patients were included (male 73.4%; mean age 57.3(12.5) years). The prevalence of DM among ACS patients was 207 (42.6%). Of these, 88 (42.1%) had poorly-controlled DM with the HbA1c > 8% and 81 (47.9%) had well control the HbA1c≤8%. Significant association was found between antihyperglycemic agents, i.e. insulin (p<0.034), metformin (p<0.038) and sulphonylurea (p<0.022). In poor control group, insulin is the most prescribed antihyperglycemic agents, 35 (37.2%) compared to well control, metformin is the highest proportion, 25 (34.7%). In multivariate analysis, only age was independently predictive of poorly controlled among DM patients with ACS (adjusted OR 0.94; 95% CI 0.90-0.97; p<0.001). Conclusion: This study found, the prevalence of DM was high among ACS patient, with half of them demonstrate poor glycemic control. This study found that increasing age was associated with a lower risk of poor glycemic control among DM patients with recent ACS.

Keywords

• diabetes mellitus
• acute coronary syndrome
• glycemic control
• prescribing pattern