Yehia Ghamin1, Mona Ayad2, Abdel Kareem A1, Mai Badra1, Asmaa Alkafafy3 and Maged Osama Aziz3*
1Department of Internal Medicine, Alexandria University, Egypt
2Department of Clinical and Chemical Pathology, Alexandria University, Egypt
3Department of Emergency and Traumatology, Alexandria University, Egypt
Background: Acute hyperglycemia is frequently used as a marker for predicting ACS adverse outcome in diabetic patients. In this study we suggest the introduction of a more accurate biomarker which could anticipate adverse outcome and length of hospital stay in ACS diabetic patients, the glycemic gap. Methods: The 100 diabetic patients who were presented to ER with ACS were prospectively followed during their hospital stay. Admission blood glucose was measured and glycemic gap was calculated using the equation (28.7 × HbA1c − 46.7). Glycemic gap then correlated with MACE and hospital stay length. Results: There was a statistically significant relation between the glycemic gap value and MACE that the ACS patients with DM may witness during their hospital stay (p=0.001). Also there was a statistically significant relation between the glycemic gap value and the length of hospital stay of ACS patients with DM with p<0.001. In the analysis of the ROC curve for glycemic gap value to predict patient have complications, the optimal cutoff value of the glycemic gap was 55 mg/dL, with maximum AUROC of 0.796 (95% CI=0.702-0.891) (sensitivity 86.11% and specificity 56.25%) regarding complication occurrence. Conclusion: Glycemic gap could be used as a biomarker for predicting MACE and duration of hospital length in diabetic patients with ACS. Glycemic gap is a better marker than admission blood glucose alone in diabetic patient presented with ACS.
Hyperglycemia; Glycemic gap; Diabetes; Acute coronary syndrome; MACE
Ghamin Y, Ayad M, Abdel Kareem A, Badra M, Alkafafy A, Osama Aziz M. Effect of Glycated Hemoglobin A1CBased Adjusted Glycemic Variables on the Outcome of Diabetic Patients Presenting with Acute Coronary Syndrome. Int J Intern Emerg Med. 2020;3(1):1027.