European Journal of Cardiovascular Medicine

Background: Diabetes mellitus is a recognized risk factor for coronary artery disease (CAD), increasing the vulnerability to adverse outcomes in patients with acute coronary syndrome (ACS). Stress-induced hyperglycemia further complicates the clinical course of ACS. This study aimed to explore the prevalence and outcomes of stress hyperglycemia and diabetes mellitus among ACS patients.

Methods: A prospective observational study was conducted at Indira Gandhi Medical College, Shimla. A total of 301 ACS patients were enrolled, categorized into known diabetics, newly diagnosed diabetics, and stress-induced hyperglycemia. Clinical parameters, risk factors, and complications were analyzed using descriptive statistics, chi-square tests, and t-tests.

Results: Among the ACS patients, the prevalence of diabetes mellitus was 21.26%, comprising 12.96% known diabetics and 8.6% newly diagnosed cases. Stress-induced hyperglycemia was observed in 20.26% of the patients. Male predominance was noted among diabetic patients. The mean age of ACS presentation was around 58-59 years. Smoking was the most prevalent risk factor (61.5%), followed by hypertension. Diabetic patients exhibited a higher prevalence of complications, particularly heart failure (29.7%). Uncontrolled diabetes was associated with a higher incidence of complications (48.5%). Stress hyperglycemia correlated with impaired fasting glucose at discharge.

Conclusion: Diabetes mellitus and stress-induced hyperglycemia contribute to adverse outcomes in ACS patients. Complications were more frequent in diabetic patients, and stress hyperglycemia was associated with impaired glucose tolerance. Effective management and follow-up of hyperglycemic patients are crucial for improved outcomes.