Stress hyperglycemia and prognosis of acute myocardial infarction in nondiabetic patients: a cross-sectional study

Keywords

Nhồi máu cơ tim cấp, Glucose máu nhập viện, Không đái tháo đường, Các biến chứng tim mạch, Tử vong. Acute Myocardial Infarction, Admission glucose
Non-diabetic, Adverse clinical events, Mortality.

Working Languages

How to Cite

Mai, T. N., Hoàng, A. T., & Hồ, A. B. (2020). Stress hyperglycemia and prognosis of acute myocardial infarction in nondiabetic patients: a cross-sectional study. Vietnam Journal of Diabetes and Endocrinology, (38), 38-46. https://doi.org/10.47122/vjde.2020.38.6

Abstract

Background: Acute hyperglycemia on admission is common in acute myocardial infarction(AMI)patients regardless of diabetic status, and is known as one of prognostic factors. However there is limited evidence on the effect of acute hyperglycemia on non-diabetic patients. Our goal is to assess if admission hyperglycemia increases the risk for in-hospital adverse clinical events and mortality after AMI in non-diabetic patients. Methods: We perform this cross-sectional study involving 128 AMI patients admitted to the Cardiovascular Emergency and Interventional Department at Hue Central Hospital between April 2017 and July 2018. We categorize patients according to their glucose levels at admission (<7,8; 7,8–11,0 and ≥11,1 mmol/L) and compare in‑hospitaladverse clinical events andmortality across these admission glucose categories. We employ logistic regression to assess the differences in outcomes across admission glucose levels while adjusting for the same covariates. Results: As compared to patients with admission glucose <7,8 mmol/L (70,3%), patients with admission glucose 7,8-11,0 mmol/L (23,4%, odds ratio OR = 2,09; 95%confidence interval CI [0,65-6,77]) and >11,1 mmol/L (6,3%, OR = 7,56; 95% CI [1,29-44,28]) are at elevated in-hospital adverse clinical events after adjustment for patients’ demographic characteristics and clinical status. Among non-diabetic patients with admission glucose 7,8-11,0 mmol/L (OR = 1,46; 95% CI [0,34-6,37]) and >11,1 mmol/L (OR = 7,82; 95%CI [1,39-43,90]) remain elevated risk for adjusted in-hospital mortality.In the multivariate analysis,an increment of 1 mmol/L in blood glucose on admission is associated with an increase in in-hospital adverse clinical events andmortality risk of 41% and 26%, respectively. Conclusions: These findings underscore clinical significance of admission hyperglycemia on in-hospital adverse clinical eventsand mortality in non-diabetic AMI patients.
https://doi.org/10.47122/vjde.2020.38.6