Prevalence of Undiagnosed Type 2 Diabetes Mellitus in Acute ST Elevation Myocardial Infarction

Abstract

Background The objective of this study was to determine the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) in ST-elevated myocardial infarction (STEMI) patients. Methods A single-center cross-sectional study involving 85 STEMI patients was conducted at Hospital Canselor Tuanku Mukhriz (HCTM). The HbA1c and FBS were taken in all patients within 24 hours of admission. A coronary angiogram was performed immediately or within 5 days of the event and the severity of the finding was calculated by using syntax score. Results Of the 85 patients, 56.6% (48) had diabetes of which 34.1% (29) had known cases of T2DM and 22.4% (19) is a newly diagnosed diabetes by using HbA1c criteria > 6.5%. There was no significant difference between HbA1c and fasting insulin levels with CAD severity. The incidence of MACE at 1-month follow-up was not different between T2DM and non-diabetes patients. Male patients of Malay ethnicity and those with dyslipidemia and hypertension were significantly associated with a higher prevalence of undiagnosed T2DM among STEMI patients. Conclusions The prevalence of newly diagnosed T2DM at the onset of STEMI was 22.4%. The HbA1c was an effective tool in detecting diabetes among STEMI patients.