PREVALENCE OF UNDIAGNOSED DIABETES MELLITUS IN ACUTE CORONARY SYNDROME (ACS) PATIENTS

Main Article Content

Syed Sofyan Muhammad
Rabia Zaheer
Shehroz Khan
Rida Masood
Anjlee Sawlani
Rashid Ali Khan

Keywords

Undiagnosed diabetes mellitus, acute coronary syndrome, prevalence, cardiovascular risk

Abstract

The prevalence of undiagnosed diabetes mellitus (DM) among patients with acute coronary syndrome (ACS) is alarmingly high, impacting clinical outcomes and necessitating improved screening strategies. This study aim to quantify the prevalence of undiagnosed DM in ACS patients, comparing diagnostic criteria such as the Oral Glucose Tolerance Test (OGTT) and HbA1c levels. The findings highlight a substantial proportion of undiagnosed DM detected by several methods. Enhanced screening protocols integrating multiple diagnostic methods are crucial for optimizing management and improving cardiovascular outcomes in this high-risk population. After conducting research across various search engines, it has been determined that there is a notably high prevalence of undiagnosed diabetes mellitus among patients with acute coronary syndrome. This highlights the importance of implementing routine diabetes screening in this high-risk group. Detecting and managing diabetes early in ACS patients has the potential to enhance clinical outcomes and alleviate the burden of cardiovascular complications.

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References

1. Bartnik M, Ryden L, Ferrari R, Malmberg K, Pyörälä K, Simoons M, et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe: The Euro Heart Survey on diabetes and the heart. European heart journal. 2004;25(21):1880-90.
2. Norhammar A, Tenerz Å, Nilsson G, Hamsten A, Efendíc S, Rydén L, et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. The Lancet. 2002;359(9324):2140-4.
3. Colombo MG, Meisinger C, Amann U, Heier M, von Scheidt W, Kuch B, et al. Association of obesity and long-term mortality in patients with acute myocardial infarction with and without diabetes mellitus: results from the MONICA/KORA myocardial infarction registry. Cardiovascular diabetology. 2015;14:1-10.
4. Timmer JR, Hoekstra M, Nijsten MW, van der Horst IC, Ottervanger JP, Slingerland RJ, et al. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment–elevation myocardial infarction treated with percutaneous coronary intervention. Circulation. 2011;124(6):704-11.
5. Suleiman M, Hammerman H, Boulos M, Kapeliovich MR, Suleiman A, Agmon Y, et al. Fasting glucose is an important independent risk factor for 30-day mortality in patients with acute myocardial infarction: a prospective study. Circulation. 2005;111(6):754-60.
6. Atlas D. International Diabetes Federation (IDF). 2000. Hallado en: http://www diabetesatlas org/resources/previous-editions html. 2000.
7. Fang M, Wang D, Tang O, Selvin E. Prevalence of chronic disease in laboratory-confirmed COVID-19 cases and US adults (2017–2018). Diabetes Care. 2020;43(10):e127.
8. Doyle-Delgado K, Chamberlain JJ, Shubrook JH, Skolnik N, Trujillo J. Pharmacologic approaches to glycemic treatment of type 2 diabetes: synopsis of the 2020 American diabetes association's standards of medical care in diabetes clinical guideline. Annals of internal medicine. 2020;173(10):813-21.
9. BABAR S, ALI SZ, ABBASI M, KHAN R, KHAN S, KHAN MI, et al. Prevalence of Diabetes Mellitus in Acute Ischemic Stroke Patients at Tertiary Care Hospital.
10. Ahmed N, Kazmi S, Nawaz H, Javed M, Anwar SA, Alam MA. Frequency of diabetes mellitus in patients with acute coronary syndrome. Journal of Ayub Medical College Abbottabad. 2014;26(1):57-60.
11. Conaway DG, O’Keefe JH, Reid KJ, Spertus J. Frequency of undiagnosed diabetes mellitus in patients with acute coronary syndrome. The American journal of cardiology. 2005;96(3):363-5.
12. Mikhail N. The metabolic syndrome: insulin resistance. Current hypertension reports. 2009;11(2):156-8.
13. Bornfeldt KE, Tabas I. Insulin resistance, hyperglycemia, and atherosclerosis. Cell metabolism. 2011;14(5):575-85.
14. Schramm TK, Gislason GH, Køber L, Rasmussen S, Rasmussen JN, Abildstrøm SZ, et al. Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people. Circulation. 2008;117(15):1945-54.
15. Members ATF, Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). European heart journal. 2013;34(39):3035-87.
16. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. The New England journal of medicine. 2011;364(9):829-41.
17. McGuire DK, Newby LK, Bhapkar MV, Moliterno DJ, Hochman JS, Klein WW, et al. Association of diabetes mellitus and glycemic control strategies with clinical outcomes after acute coronary syndromes. American heart journal. 2004;147(2):246-52.
18. Wang CCL, Reusch JE. Diabetes and cardiovascular disease: changing the focus from glycemic control to improving long-term survival. The American journal of cardiology. 2012;110(9):58B-68B.
19. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovascular diabetology. 2018;17:1-19.
20. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). European heart journal. 2020;41(2):255-323.
21. Bhatt DL, Hulot J-S, Moliterno DJ, Harrington RA. Antiplatelet and anticoagulation therapy for acute coronary syndromes. Circulation research. 2014;114(12):1929-43.
22. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. New England journal of medicine. 2004;350(15):1495-504.
23. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. 2002.
24. Abdullatef W, Al-Aqeedi R, Dabdoob W, Hajar H, Bener A, Gehani A. Prevalence of unrecognized diabetes mellitus in patients admitted with acute coronary syndrome. Angiology. 2013;64(1):26-30.
25. Karamat MA, Raja UY, Manley SE, Jones A, Hanif W, Tahrani AA. Prevalence of undiagnosed type 2 diabetes in patients admitted with acute coronary syndrome: the utility of easily reproducible screening methods. BMC endocrine disorders. 2017;17:1-8.
26. Bronisz A, Kozinski M, Magielski P, Fabiszak T, Gierach J, Swiatkiewicz I, et al. Value of oral glucose tolerance test in the acute phase of myocardial infarction. Cardiovascular Diabetology. 2011;10:1-7.
27. Lewczuk A, Hirnle T, Sobkowicz B, Sawicki R, Tomaszuk-Kazberuk A, Knapp M, et al. Glucose metabolism abnormalities after acute myocardial infarction in patients with one-vessel coronary artery disease, treated with primary percutaneous coronary intervention–1-year follow-up. Przegląd Kardiodiabetologiczny/Cardio-Diabetological Review. 2009;4(1):3-10.
28. Knudsen EC, Seljeflot I, Abdelnoor M, Eritsland J, Mangschau A, Arnesen H, et al. Abnormal glucose regulation in patients with acute ST-elevation myocardial infarction-a cohort study on 224 patients. Cardiovascular diabetology. 2009;8:1-8.

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