Association between Admission Hyperglycemia and In-Hospital Mortality among Patients Presenting with Acute Coronary Syndrome: A Prospective Cohort Study

Abstract

Objectives: To determine the association between admission hyperglycemia and in-hospital mortality among patients presenting with acute coronary syndrome. Methodology: This prospective cohort study was conducted in the Department of Cardiology, Jinnah Hospital, Lahore, Pakistan, between May and November 2023. Ninety consecutive patients diagnosed with ACS were enrolled and categorized into two groups according to admission random blood glucose concentration: the hyperglycemia (exposed) group (>140 mg/dL) and the normoglycemia (unexposed) group (≤140 mg/dL). Participants were followed throughout hospitalization for the occurrence of all-cause in-hospital mortality within seven days of admission. Results: A total of 90 patients were included in the analysis, comprising 54 (60.0%) males and 36 (40.0%) females, with a mean age of 54.28 ± 10.34 years. Patients in the hyperglycemia group had significantly higher admission blood glucose concentrations than those in the normoglycemia group (315.07 ± 87.86 mg/dL vs. 119.42 ± 11.39 mg/dL, p <0.001). In-hospital mortality occurred in seven patients (15.6%) in the hyperglycemia group, whereas no deaths were observed in the normoglycemia group. Fisher's exact test demonstrated a statistically significant association between admission hyperglycemia and in-hospital mortality (p = 0.012). Conclusion: Admission hyperglycemia was significantly associated with increased short-term in-hospital mortality among patients presenting with acute coronary syndrome. Although an independent prognostic relationship could not be established because of the limited number of outcome events and inability to perform multivariable adjustment, admission blood glucose may serve as a simple, inexpensive, and readily available marker for early risk stratification in patients with ACS.