Paper Title
A Study of Plasma Glucose Levels and Glycosylated Hemoglobin (Hba1c) on Admission As A Prognostic Indicator of Acute Myocardial Infarction

Abstract
Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The risk factors for myocardial infarction are divided into non-modifiable (irreversible) and modifiable (reversible). Glycosylated hemoglobin (HbA1c) is an important test that should be done in non-diabetic hyperglycemic patients and diabetic patients who have not been tested recently. Hence the current study was undertaken to study the effects of plasma blood glucose levels on admission and glycosylated hemoglobin (HbA1c) on the complications and outcome of acute myocardial infarction. Aims and Objectives: Study of plasma glucose levels and glycosylated hemoglobin (HbA1c) on admission as a prognostic indicator of Acute Myocardial Infarction. Materials & methods: This prospective cross-sectional study examined the prognostic value of admission plasma glucose levels and glycosylated hemoglobin (HbA1c) in acute myocardial infarction (MI). Conducted over one year at D.Y. Patil Hospital, the study included 100 patients (65 male, 35 female) admitted with acute MI.Patients were categorized into STEMI and NSTEMI groups based on ECG findings, and further divided into diabetic (HbA1c>7%) and non-diabetic (HbA1c<7%) groups. The study assessed glucose levels, HbA1c levels, and their correlation with complications and outcomes in acute MI patients. Results:We found higher mean glucose (172.4 mg/dLvs 135.2 mg/dL) and HbA1c levels (8.5% vs 6.2%) in diabetic patients compared to non-diabetics. Diabetic patients experienced a higher incidence of complications, including arrhythmias, cardiac failure, and cardiogenic shock. Notably, all six mortalities within 72 hours of admission occurred in diabetic patients, indicating worse outcomes and higher mortality rates in this group.The study found a significant correlation between glycemic profile and complications/outcomes in diabetics versus non-diabetics. These findings underscore the importance of blood glucose as a prognostic marker in acute MI. Additionally; the study highlights the utility of HbA1c in differentiating between stress hyperglycemia and diabetes in acute MI patients. Conclusion: In conclusion, this research emphasizes the value of assessing plasma glucose and HbA1c levels on admission for predicting complications and outcomes in acute MI patients, particularly in distinguishing between diabetic and non-diabetic individuals. Keywords - Acute Myocardial Infarction, Plasma Glucose, Glycosylated Hemoglobin (HbA1c), Prognostic Indicator, Diabetes Mellitus