الفهرس 
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Abstract
Diabetes Mellitus is considered a strong risk factor for acute coronary syndromes such as myocardial infarction and unstable angina.
This risk is extended from normal glucose level to diabetic range.
So the pre diabetic conditions such as impaired glucose tolerance and impaired fasting glucose are considered as risk factors for cardiovascular events.
Also glycosylated HbA1c is correlated to the degree of hyperglycemia and the risk for coronary events.
Objective:
The objective of this study is to assess blood glucose levels and glycosylated HbA1c measurements in patients with acute coronary syndromes who were known to be diabetic on admission to the coronary care unit of Sohag University Hospital during the last year and the following six months.
Methods:
This study was done on 250 patients presented with acute coronary syndromes either ST segment elevation myocardial infarction (52.4%), non ST elevation myocardial infarction (8.8%), recent LBBB (9.6%) and unstable angina (29.2%) and with previous history of diabetes mellitus who were subjected to:
1- Complete history taking.
2- Complete physical examination.
3- Laboratory investigations:-
- Admission plasma glucose level.
- Glycosylated HbA1c.
- Serum Creatinine.
- Lipid profile.
3- ECG.
Results:
We found a high prevalence of patients admitted to our CCU at Sohag University Hospital with ACS who previously known to be diabetics and there age group were classified into three groups:
• (25-50) years with a percentage of 12.4%.
• (51-75) years with a percentage of 69.6%.
• (76-100) years with a percentage of 18%.
Also we found that male more than female gender as follow:
• Male sex had 58.8% of percentage of admission while female sex percentage was 41.2%.
• Most of patients admitted were among age group (51-75) years which were mostly male sex 89 male patients and 85 female patients.
• About smoking on our study 130 patients were not smoker 93 were smoker, 14 were stop smoking and 13 were ex smoker.
• Positive family history of diabetes was highly found.
We also found high percentage of uncontrolled patients.
Patients admitted had higher blood levels of admission plasma glucose, high laboratory blood glucose level and glycated Hb A1C.
Recommendations:
from over all and on the basis of scientific studies done on diabetics with ACS we should say that diabetes is a dangerous disease and can lead to several problems and can lead to death and several items should taken on considerations about this disease:
• Diabetic patients should be regular on their treatment to avoid complications.
• Diabetic patients should follow up their blood sugar regularly.
• They should seek medical advice if they felt abnormality as high blood sugar manifestations or hypoglycemia or chest pain as diabetes increase incidence of CVD, stroke.
• If the patient feel chest pain ECG and treatment of ACS should be taken if the ECG show abnormality suggesting the presence of CVD as IHD (unstability) and AMI Echocardiography should be done to confirm the diagnosis and cardiac enzymes.
Conclusion:
from our study we found that numbers of male patients admitted to our CCU at Sohag University Hospital were more frequent than female sex.
We found also High admission plasma glucose and high percentage of HBA1C which means high percentage of uncontrolled patients and high percentage of patients with positive family history of diabetes.
Our study also show that patients who previously known to be diabetics and admitted to our CCU during the last year and the following six months were more on insulin but irregular on treatment.
Glycosylated hemoglobin A1C was specific for detection of previously undiagnosed diabetic patients presented with acute coronary syndrome, also glycated HbA1c blood level was high in complicated patients during hospital admission.