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Hyperglycaemia following Acute Myocardial Infarction: The Contribution of Undiagnosed Diabetes
Author(s) -
Oswald G. A.,
Yudkin J. S.
Publication year - 1987
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1987.tb00833.x
Subject(s) - medicine , myocardial infarction , diabetes mellitus , cardiology , intensive care medicine , endocrinology
We studied 397 patients admitted to hospital with acute myocardial infarction (AMI) to validate an admission level of haemoglobin A lc (HbA lc ) diagnostic for previously unknown diabetes mellitus by assessing glucose tolerance after 3 months. In 38% of survivors clearly abnormal HbA lc level (>7.8) was 100% sensitive and 99% specific for diabetes with fasting hyperglycaemia, although the sensitivity fell to 67% when three diabetic subjects without fasting hyperglycaemia were included. Admission hyperglycaemia (plasma glucose ≥11 mmol/l) was present in 20% of patients with AMI, of whom only one in five had levels of HbA 1c indicating prior diabetes. Glycosylated haemoglobin is a more sensitive and specific test for diabetes in patients with AMI than admission hyperglycaemia. Undiagnosed diabetes was found in 4.3% of subjects with AMI who contributed 9.6% of hospital mortality.