BACKGROUND: Hyperglycemia on admission in patients with acute coronary syndromes is common, and it is a powerful predicator of increased risk of in hospital complications in patients with and without diabetes mellitus, high sensitivity c- reactive protein (hs- CRP) is a cardiovascular risk marker in patients
with acute coronary syndrome.
OBJECTIVES:
1. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome with admission hyperglycemia whatever diabetic or not.
2. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome without admission hyperglycemia.
3. To compare the results of the above two groups and assess the prognostic value of admission glucose and hs -CRP levels in hyperglycemic patients with acute coronary syndromes.
 
DESIGN AND SETTING: Prospective study, at Sohag university hospital in Egypt.
 
METHODS: We measured the blood glucose, hs -CRP, cardiac enzymes and HBAIC levels at admission in 100 consecutive patients with ACS. Glucose was categorized as ≤11.1mmol=200 mg/dl. hs -CRP negative 3 mg, HBAIC ≤ 6.5% or ≥ 6.5).
 
RESULTS: In our study reveals a statistically significant relation between levels of admission glucose and left ventricular function (LV failure, pulmonary edema and cardiogenic shock) or arrhythmias in hyperglycemic patients with ACS (P< 0.0001).
Also there is a significant relation between level of hs- CRP and LVF and type of myocardial infarction in-hospital complications.                                                                                                  
Also there is insignificant relation between HBAIC levels and left ventricular function in ACS at admission.                                                                                                                        
CONCLUSION: We conclude that elevated admission glucose appears a more important in predicting in-hospital and short term complications particularly left ventricular failure and cardiogenic shock in patients with acute coronary syndromes. Also the increased levels of hs- CRP are a predictor for severity and extent of myocardial damage and left ventricular function especially in STEMI.
The synergistic effect of associated both stress hyperglycaemia and hs- CRP is a strong predictor for poor ACS outcome.