Mahendran DC, Hamilton G, Weiss J, et al. - Researchers conducted this prospective observational cohort study to test the assumption that dysglycemia including in the prediabetes range affects most patients admitted with the acute coronary syndrome (ACS) and correlates with worse outcomes. For this analysis, consecutive inpatients (aged ≥ 54 years) with ACS were tested and characterized into diabetes (prior diagnosis/ HbA1c ≥ 6.5%, ≥ 48 mmol/mol), prediabetes (HbA1c 5.7-6.4%, 39-47 mmol/mol) and no diabetes (HbA1c ≤ 5.6%, ≤ 38 mmol/mol) groups. Investigators found that 847 consecutive inpatients presented with ACS over 2 years. Diabetes, compared with no diabetes, was linked to higher odds of acute pulmonary oedema, a longer length of stay and, 12-month ACS recurrence after adjustment, whereas no important connections were identified for prediabetes. The elevated incidence of dysglycaemia and association with poorer clinical results justifies routine HbA1c testing to identify people who may benefit from anti-hyperglycaemic cardioprotective agents and alteration of lifestyle to avoid prediabetes progression.