To determine the relationship between acute hyperglycemia and in-hospital mortality in black Africans with acute coronary syndromes (ACS).

From January 2002 to December 2017, 1168 patients aged ≥18 years-old including 332 patients with diabetes (28.4%) consecutively presented to the intensive care unit of the Abidjan Heart Institute for ACS. Baseline data and outcomes were compared in patients with and without hyperglycemia at admission (>140mg/dl). Predictors for death were determined by multivariate logistic regression.

The prevalence of admission hyperglycemia was 40.6%. It was higher in patients with diabetes (55.3%). In multivariate logistic regression, acute hyperglycemia (HR=2.33 [1.44–3.77]; P<0.001), heart failure (HR=2.22 [1.38–3.56]; P=0.001), reduced left ventricular ejection fraction (HR=6.41 [3.72–11.03]; P<0.001, sustained ventricular tachycardia or ventricular fibrillation (HR=3.43 [1.37–8.62]; P=0.008) and cardiogenic shock (HR=8.82 [4.38–17.76]; P<0.001) were predictive factors associated with in-hospital death. In sub-groups analysis according to the history of diabetes, hyperglycemia at admission was predictor for death only in patients without diabetes (HR=3.12 [1.72–5.68]; P<0.001).

In ACS patients and particularly without history of diabetes, admission acute hyperglycemia is a potential threatening condition. Appropriate management, follow-up and screening for glucose metabolism disorders should be implemented in these patients.