Title: An Observational Study on Prognostic Significance of Admission Blood Glucose Level in ST Elevation Myocardial Infarction
Authors; Dr Ganesh.K, Prof. Dr S.Balasubramaniyan.M.D., Dr N.Paari M.D.
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.110
Abstract
Aims and Objectives: To determine the prognostic significance of admission blood glucose level among nondiabetic patients presenting with ST elevation myocardial infarction (STEMI).
Method: This is a prospective observational study conducted from November 2017 to October 2019. A total of 100 consecutive patients admitted with ST elevation myocardial infarction in CCU, RMMCH were included after satisfying the inclusion and exclusion criteria. All the patients were subjected to complete history taking and clinical examination. Investigations like ECG, cardiac enzyme, admission blood glucose, HbA1c, Echocardiogram were done in all patients. Patients in the study were divided into three groups i.e. Group A (patients with blood glucose level <140 mg/dl), Group B (patients with blood glucose level between 140 and 200 mg/dl), Group C (patients with blood glucose level >200 mg/dl). Group A had 21 participants group B had 42 and Group C 37.
Results
- In this study among those who developed cardiogenic shock 66.7 % were in the group C, and 33.3 % were in group B and no patient in Group A.
- Among those who developed pulmonary edema 66.7% were in the Group C, and 26.7 % were in group B and in Group A 6.7%.
- Among those who developed arrhythmias 54.5% were in the Group C, and 27.3% were in group B and in Group A 18.2%.
- Among those patients who had ejection fraction of <40%, 6% were in Group C
- In total 4 patients died before hospital discharge, of them 3 belong to Group C and one belong to Group B.
Conclusion: From the above observations it has been concluded that hyperglycemia at the time of admission is very common in patients presenting with ST elevation myocardial infarction. It is associated with greater myocardial injury and an increased risk of major adverse cardiovascular events. Therefore in all patients with STEMI random blood sugar level should be estimated at the time of admission which will predict cardiovascular complications and could be used in the risk stratification of these patients.
Keywords: Admission blood glucose, ST elevation myocardial infarction, adverse cardiovascular events.
