DIFFERENCE BETWEEN PATIENTS WITH HIGH GLUCOSE LEVEL AND NORMAL GLUCOSE LEVEL TO MAJOR ADVERSE CARDIAC EVENTS IN IN-WARD PATIENTS IN RSUP DRSARDJITO, YOGYAKARTA

Numerous studies have proved a physiological link between high glucose levels and adverse outcomes which may be responsible for the prognostic value of hyperglycemia in the ACS setting. However more research has to be done to further strengthen the relationship between these two factors. The aim of this study is to determine if there is a link between the admission serum glucose level and the occurrence of major cardiac events while hospitalized in patients presenting with acute coronary syndrome in RSUP Dr Sardjito. It also functions to further strengthen the relationship between high glucose levels. The study was a retrospective cohort of which 195 patients diagnosed and admitted with ACS in the intensive cardiac care unit (ICCU) of RSUP Dr Sardjito, Yogyakarta anytime from 2010 and 2011. The serum glucose levels were taken from the routine blood test done upon admission and the patients were categorized into 2 groups, the exposed hyperglycemic group (>140mg/dL) and the nonexposed normoglycemic one (65-140mg/dL). The data was then analysed using chi-square with a confidence interval of 95%. Out of the 195 patients only 31 patients developed MACE, 20 from the hyperglycemic group and 11 from the normoglycemic group with a 25% and 9.57% occurrence of MACE in each group respectively. The relative risk for the exposed group was 2.614. There is more than a two-fold (RR:2.614) chance of an ACS patient with high admission glucose level developing MACE with a p-value of 0.004. However after adjusting using a binary logistic regression model with several confounding factors such as male sex, diabetes, obesity &dyslipidemia the odds ratio was 4.656 with a p-value of 0.001 indicating a strong association between hyperglycemiaand MACE