Title: Prevalence and prognostic implication of stress hyperglycemia in patients of acute ST elevation myocardial infarction in a tertiary care centre in Eastern India
Authors: Biswarup Sarkar, MD. DM, Sharmistha Chatterjee MD, Biswajit Majumder MD DM FACC FSCAI
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.52
Abstract
This observational study was carried out in non-diabetic patients admitted with ST elevation MI within 24 hrs of onset of chest pain with the aim of investigating the association and prognostic implications between stress hyperglycemia and STEMI The study population comprised of 58 patients, aged 30-70 years], presenting with acute ST elevated myocardial infarction (MI) within 24 hours of chest pain admitted in the Department .Patients who were admitted more than 24 hrs from the onset of symptoms, known diabetics, and those with renal failure (creatinine>1.5), inflammatory disorders, infection and malignancy were excluded. logistic regression analysis admission sugar levels were found to be a significant predictor of MPI, WMS, WMSI, CRP.
In conclusion, an association among admission blood glucose level, left ventricular EF, WMS, WMSI, MPI, CRP and CPKMB were observed in ST elevation AMI patients in our study.
Keywords: stress hyperglycemia, acute STEMI, cardiac enzymes, inflammatory markers, prognosis, echocardiographic parameters.
References
1. Capes SE, Hunt D, Malmberg K, . Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000;355(9206):773–778. Google Scholar CrossRef, Medline
2. A. Dirkali, Tj. van der Ploeg M. Nangrahary J.H. Cornel. The impact of admission plasma glucose on long-term mortality after STEMI and NSTEMI myocardial infarction. October 1, 2007Volume 121, Issue 2, Pages 215–217 international journal of cardiology.
3. Kosiborod M, Rathore SS, Inzucchi SE, Masoudi FA, Wang Y, Havranek EP, et al. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation. 2005;111(23):3078–3086. [PubMed]
4. Meier JJ, Deifuss S, Klamann A, Launhardt V, Schmiegel WH, Nauck MA. Plasma glucose at hospital admission and previous metabolic control determine myocardial infarct size and survival in patients with and without type 2 diabetes: the Langendreer Myocardial Infarction and Blood Glucose in Diabetic Patients Assessment (LAMBDA) Diabetes Care. 2005;28(10):2551–2553. [PubMed]
5. Nordin C, Amiruddin R, Rucker L, Choi J, Kohli A, Marantz PR. Diabetes and stress hyperglycemia associated with myocardial infarctions at an urban municipal hospital: prevalence and effect on mortality. Cardiol Rev. 2005;13(5):223–230. [PubMed]
6. Gokhroo R, Mittal SR. Electrocardiographic correlates of hyperglycemia in acute myocardial infarction. Int J Cardiol 1989;22:267–269.
7. Hieesmayr M. Hyperglycaemia and outcome after myocardial infraction and cardiac surgery: So what? Semin Cardiothorasic Vasc Anesth 2006; 10: 220-3.
8. H. Wei Christina , Litwin Sheldon E. Hyperglycemia and Adverse Outcomes in Acute Coronary Syndromes: Is Serum Glucose the Provocateur or Innocent Bystander? Diabetes Volume 63, July 2014
9. Wahab N, Cowden E, Pearce N, et al. Is blood glucose an independent predictor of mortality in acute myocardial infraction in the thrombolytic era? J Am Coll Cardiol 2002; 40: 1748-54.
10. 10.Wong V, Ross D, Park D, et al. Hyperglycaemia: still an important predictor of adverse outcomes following AMI in reperfusion era. Diabetes Res Clin Pract 2004; 64: 85-91.
11. Marfella R, Nappo F, De Angelis L et al. The effect of acute hyperglycaemia on QTc duration in healthy man. Diabetologia 2000; 43:571–575.
12. Ishihara M, Inoue I, Kawagoe T et al. Impact of acute hyperglycemia on left ventricular function after reperfusion therapy in patients with a first anterior wall acute myocardial infarction. Am Heart J 2003; 146:674–678.
13. Iwakura K, Ito H, Ikushima M, Kawano S et al. Association betweenhyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction. J Am Coll Cardiol 2003;41:1–7.
14. 14.Kersten JR, Schmeling TJ, Orth KG et al. Acute hyperglycemia abolishes ischemic preconditioning in vivo. Am J Physiol 1998 ;275:H721–H725.
15. Poulsen SH, Jensen SE, Tei C et al. Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction. J Am Soc Echocardiogr 2000;13:723–730.
16. Baele G, Mussche M, Vermeire P. Serum fibrin-fibrinogen products in acute myocardial infarction. Lancet 1972;1:689–690.
17. Chandler AB, Chapman I, Erhardt LR et al. Coronary thrombosis in myocardial infarction. Report of a workshop on the role of coronary thrombosis in the pathogenesis of acute myocardial infarction. Am J Cardiol 1974;34:823–833.
18. Oswald GA, Smith CC, Delamothe AP et al. Raised concentrations of glucose and adrenaline and increased in vivo platelet activation after myocardial infarction. Br Heart J 1988;59:663–671.
19. Ceriello A. Coagulation activation in diabetes mellitus: the role of hyperglycaemia and therapeutic prospects. Diabetologia 1993;36:1119–1125.
20. Jones RL, Peterson CM. Reduced fibrinogen survival in diabetes mellitus a reversible phenomenon. J Clin Invest 1979;63:485–493.
21. Ceriello A, Giugliano D, Quatraro A et al. Hyperglycemia may determine fibrinopeptide A plasma level increase in humans. Metabolism 1989;38:1162–1163.
22. Ceriello A, Giacomello R, Stel G et al. Hyperglycemia-induced thrombin formation in diabetes. The possible role of the oxidative stress. Diabetes 1995;44:924–928.