Impaired glucose tolerance (IGT); diabetes and prediabetes, is common among patients with CAD. Diabetic patients usually have a worse clinical course, so it is important to detect diabetes and even prediabetes, since progress to T2DM can be retarded by lifestyle interventions. It is known that OGTT is recommended in patients with CAD, but still HbA1c and FPG are more clinically applicable. Our study aimed to assess the incidence of IGR in patients with ACS using HbA1 and FPG as most of previous

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... studies used OGTT and to study the impact of IGR on in hospital clinical outcomes and severity of coronary arteries lesions using Syntax score. Material and Methods: prospective study included 247 patients with ACS admitted to CCU of Assiut university hospital. To all included patients, HbA1c, FPG and coronary angiography were done and syntax score was calculated. Patients were observed to detect in hospital complications and mortality. Results: The enrolled patients were non-diabetics {18 patients (7.3%)} and {229 (92.7%)} either prediabetic or diabetic. In hospital complications occurred in 83 patients, 21 prediabetic, 31 newly diagnosed diabetes and 31 known diabetics. Syntax score was significantly less in non-diabetics compared to prediabetics, newly diagnosed diabetes or known diabetics. HbA1c showed a significant correlation with syntax score (p<0.000, r 0.235), while FPG did not. Conclusion: Previously undiagnosed IGR has a high incidence among ACS patients. FPG and HbA1c can predict in hospital clinical outcomes. HbA1c but not IFG has a correlation to Syntax score.