A Study of Association Between Glycosylated Haemoglobin Level and Outcome in Acute Coronary Syndrome Patients with type 2 Diabetes Mellitus”

Abstract

Background: Diabetes Mellitus (DM) is a well-established risk factor for cardiovascular diseases, significantly increasing the incidence and severity of Acute Coronary Syndrome (ACS). Chronic hyperglycemia accelerates atherosclerosis, contributing to poor cardiovascular outcomes. Glycosylated hemoglobin (HbA1c) is a reliable marker of long-term glycemic control, and its association with ACS prognosis remains a topic of clinical interest.

Aim: This study aims to evaluate the relationship between HbA1c levels and clinical outcomes in ACS patients with Type 2 Diabetes Mellitus (T2DM), focusing on mortality, cardiac dysfunction, and other complications.

Materials & Methods: A cross-sectional study was conducted at Aarupadai Veedu Medical College and Hospital, Pondicherry, including 205 ACS patients with T2DM. Patients were evaluated based on clinical presentation, laboratory investigations, and echocardiographic findings. HbA1c levels were analyzed in relation to mortality, diastolic dysfunction, arrhythmias, and mitral regurgitation. Statistical analysis was performed using SPSS v23.0, with a p-value of <0.05 considered significant.

Results: The mean age of the study population was 54.33 years, with 46.3% males and 53.7% females. Hypertension, smoking, and alcohol consumption were present in 46.3%, 20.5%, and 29.3% of patients, respectively. The mean HbA1c was 8.5%. Mortality was observed in 9.3% of cases, but no significant association was found between HbA1c levels and mortality. However, patients with diastolic dysfunction had significantly higher HbA1c levels (p<0.05). No significant correlation was observed between HbA1c and arrhythmias or mitral regurgitation.

Conclusion: While HbA1c was not a direct predictor of mortality in ACS patients with T2DM, its association with diastolic dysfunction suggests that poor glycemic control may contribute to adverse cardiac outcomes. Effective glycemic management may help improve long-term cardiovascular prognosis in these patients.