Endocrine Abstracts

Introduction: The admission glucose may be a predictor of survival and is independently associated with infarct size and higher mortality in patients with ACS. Hyper-homocysteinemia in patients with ischaemic heart disease represents a strong predictor of vascular morbidity. The role of glucose increase above normal levels in non-diabetic patients with ACS is not adequately defined. The aim was the assessment of dependence between admission blood glucose and homocysteine concentrations in patients with ACS.

Material and methods: Ninety-two pts (33F; 59 M), aged 34–82 mean 63.5±12.0 years. In whole group, there were 20 (21.7%) pts with previously diagnosed diabetes. In the time of admission into Intensive Care, glucose and homocysteine levels applying chemiluminescence method (IMMULITE, DTC) in the venous blood had been measured.

Results: In the whole group, myocardial infarct was diagnosed in 52 (56.5%) pts and ACS without acute cardiac necrosis in 40 pts. Mean admission glucose and homocysteine levels in diabetic patients group were 163±62.8 (range 86–264) mg% and 13.1±6.5 (range 6.9–34.3; F 13.8±8.3; M 12.6±4.8) μmol/l respectively. Merely in 12 (16.4%) non-diabetics with ACS admission glucose level didn’t exceed 100 mg% (group 1). Mean level glucose and HC in these group was 95.7±3.8 mg% and 12.2±2.6 (F10.9±2.5; M 12.9±2.4) μmol/l, respectively. In the other patients without previously diagnosed diabetes: in 27 (40%) subjects randomly measured glycemia at admission ranged from 101 to 130 mg% (mean 112.1±8.1 mg%) and mean HC 13.8±5.8 (F 13.9±4.9; M 13.7±6.3) μmol/l (group 2); in 16 (21.9%) patients between 131 and 160 mg% (mean 139.9±7.2 mg%) and HC 15.6±6.4 (F 16.3±4.9; M 15.4±7.0) μmol/l (group 3); in 18 (24.6%) above 160 mg% (mean 201.6±34.1) and HC 18.0±9.8 μmol/l (F 17.4±12.8; M 18.5±8.0) (group 4). The myocardial infarction was diagnosed in the 25; 51.8; 56.3 and 72.2% patients of studied groups without diabetes and in 70% of diabetics.

Conclusion: The higher levels of ABG have been connected with the higher HC blood levels as well as with the higher percentage of patients with myocardial infarction.