0320 : Prevalence of glucose disoders in a cohort of patients hospitalized for ACS in coronary care unit, and security and efficiency of an intraveinous insulin protocol adapted on glycemic kinetic

BackgroundGlycemic variabilities have a negative impact on the morbidity and mortality of acute coronary syndromes (ACS). A strict glucose monitoring is recommended on admission in Coronary Care Unit (CCU). The aims of our study were to assess the prevalence of various glucose disorders (diabete mellitus, impared fasting hyperglycemia, glucose intolerance, stress hyperglycemia) among patients hospitalized for ACS, and to assess the efficency and security of an IV insulin protocol adapted on glycemic kinetic, to decrease the risk of hypoglycemia, and for which the goal was to stabilized glycemia between 1.10 and 1,40g/l.Population and MethodThis retrospective monocenter study concerns all patients admitted for ACS (STEMI and NSTEMI) in Troyes hospital from May 2012 to May 2013. The different glycemic parameters, capillarious and veinous were collect through analysis of medical reports.Results164 patients were included. The mean age was 65±13 years. Among them, 97 (59%) had diabete mellitus, and 8 (5%) had an intermediate disorder. Stress hyperglycemia was observed in 10 patients (11%) free from glucose abnormalities. Among the patients without hystory of diabete mellitus and with hyperglycemia on admission, 53% were authentic diabetics. The IV insulin protocol was initiated in 36 patients with a average baseline blood glucose 2.7±0,7g/l. thirty-two were diabetics (31 type 2 and 1 and type 1) and diabete mellitus has been found on the occasion of the SCA in 4 of them with HbA1c >6.5%. The average time to reach a glycemia within the target range was 12.7±11h. Only 3 patients (8%) had moderate hypoglycemia (