Original paper
Glucometabolic disorders in patients with acute coronary syndrome

Aims: Estimation of impaired glucose tolerance (IGT) and diabetes (DM) in patients with acute coronary syndrome (ACS) without previously diagnosed DM. Methods: BMI, WHR, blood pressure, total cholesterol, LDL, HDL and triglycerides were assessed. Metabolic syndrome was diagnosed according to NCEP ATP III criteria. Patients were divided based on the OGTT results into 4 groups: 0-NGT, I-IFG, II-IGT and III-DM. Diabetic education was provided and the level of knowledge about healthy lifestyle was checked during hospitalization and 3 months later. Results: The study comprised 140 patients aged 57.±9.7 (range 28-80), 20 (14%) women and 120 (86%) men, of whom 116 (83%) were treated with PTCA, while the remaining ones were treated pharmacologically. On the basis of OGTT on day 5 of hospitalization IFG was diagnosed in 11%, IGT in 33% and DM in 23%. IFG was found in 5%, IGT in 22%, and DM in 14% after 3 months. A close correlation between the level of glycaemia in OGTT and the number of involved coronary arteries was noted (p<0.007). Metabolic syndrome was common in the IGT/DM group (p<0.01). Conclusions: Unknown glucometabolic disorders were observed on the 5th day of hospitalization in 67% of patients and after 3 months in 41%. There is a close correlation between the blood glucose level in OGTT and the number of involved coronary arteries. 3 months after hospitalization due to ACS in 26% of patients glycaemic level normalized, which might have been the result of education and change in lifestyle.