الفهرس 
Pathophysiology of Diabetic Vascular DiseaseOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSION
Diabetes mellitus is associated with a high risk of CHD (Kannel et al, 2000) and subjects with diabetes have a substantially increased risk of death after ACS as compared with non diabetic age matched controls (Malemberg K et al,1999)
high blood glucose levels in patients admitted with ACS are common and are associated with an increased risk of death in both diabetics and non diabetics(Capes SE et al,2000).
Admission hyperglycemia is a strong risk factor for mortality in patients with ACS and may be even stronger than a previous history of diabetes. Recent evidences have shown that chronic glucose deregulation, as assessed by glycolysated hemoglobin (HBA1c), levels may also be of prognostic value with a regard to future the cardiovascular disease. ( Foo k et al,2003)
The study included 120 cases presented to the emergency department and admitted CCU of Ain shams university hospitals and National Heart Institute with ACS (unstable angina – non-STEMI and STEMI) in the period between July 2013 and July 2014.
Patients were stratified into 2 groups based on HbA(1c) level, checked on admission (optimal control group, HbA(1c) < 7% (60 poatients) ; suboptimal control group, HbA(1c) ≥7%) (60 patients).
All patients then were subjected to full history taking, physical examination, resting 12 lead ECG, chest xray,echocardiography,coronary angiography and laboratory investigations in the form of random blood
sugar on admission (RBS), glycosylated hemoglobin (HBAIc), serum lipids, Troponin I, cardiac specific creatine phosphokinase (CKMB) and high sensitivity C- reactive protein (hs-CRP).
All patients were followed up during hospital stay prospectively for major adverse cardiovascular events (MACE) (death, MI or repeat coronary revascularization of the target vessel), other complications, coronary angiographic data and management during hospital stay.
Statistical analysis then done and the results were tabulated and statistical analysis was performed using IBM compatible PC computer and by means of statistical software package namely (SPSS), The results were analyzed by the suitable statistical methods, which included Mean, standard deviation (SD) and Student’s t-test, Data were considered significant at a p value <0.05 and non significant at a p value >0.05.
Our results revealed that there were a statistically significant difference between group A and group B as regards ejection fraction
,angiographic data in the form of those who have three vessel disease and or left main disease and inhospital morbidty including incidence of congestive heart failure and cardiogenic shock as complications. However it failed to show any statistically significant difference as regard inhospital mortality.
from our study we can conclude that:
• Glycosylated hemoglobin is an important predictor for inhospital morbidity in patients with acute coronary syndrome.
• Glycosylated hemoglobin has no impact on inhospital mortality in patients with acute coronary syndrome.