Study of glycemic control type effects in hospital prognosis of diabetic patients with acute Coronary syndrome

Document Type : Research Paper

Authors

1 Associate Professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Abstract:
Introduction: Prevalence of cardiovascular disease in diabetic patients is more than general population and its adverse events are more common, though  multiple different protocol of glucose control in acute coronary syndrome were proposed , in this study  two different protocol of controlling blood sugar level for decreasing hospital adverse events were compared.
Method:
200 diabetic patients with acute coronary syndrome in Imam Reza Cardiology Department after 48 hours insulin therapy randomly divided in to two groups: intensive control, in this  group we checked  blood glucose level before meal and two hours post prandial (6 times a day) and insulin depending on chart  with target fasting glucose70-110 mg/dl and two hours post prandial lower than 180 mg/dl. second  group was conventional control with checking fasting blood glucose level daily, with using the diabetes treatment like before admission  with target of fasting glucose 70-130 mg/dl. All patients have been visited  daily and major  adverse cardiac (MACE) events were recorded.
Results:
Overall 12% of all  patients had recurrent ischemia (10% of intensive group versus 14% in conventional group, p=0.0514), Reinfarction  in one patient of conventional group (p=1.000), arrhythmia in 5 patients (2.5%), 3 patients (3%) of conventional  group versus 2 patients(2%) of intensive group (p=1.000), ventricular dysfunction in 85% of patients, 84 patients (84%) of intensive group versus 86 patients (86%) of conventional group (p=0.843)
and intra hospital mortality rate was 4%, 5 patients (5%) in conventional versus 3 patients (3%) in intensive group, (p=0.721).
Conclusion: depending on the study  we didn’t find any  significant differences  in major  adverse cardiac events in two groups .
 

Keywords

References

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Medical Journal of Mashhad university of Medical Sciences
Volume 61, Issue 6
May and June 2019
Pages 1328-1340

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