Impact of Acute and Chronic Hyperglycemia on in-Hospital Outcomes of Patients with Acute Myocardial Infarction
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 4
Abstract
Introduction: Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide. It has been reported that hyperglycemia causes oxidative stress, enhances inflammation, induces apoptosis and activates coagulation, which deteriorate myocardial damage in the setting of ischemia. Material and Methods: This cross sectional time bound study consisted of 120 patients. Acute hyperglycemia was defined as admission plasma glucose ≥200mg/dl and chronic hyperglycemia as hemoglobin A1c≥6.5%. 120 patients were divided into those with acute hyperglycemia and those without acute hyperglycemia, those with chronic hyperglycemia and those without chronic hyperglycemia and were analysed between them. All those patients with sepsis, trauma, stroke, Patients with chronic kidney disease: defined by glomerular filtration rate <30ml/min/1.73 m2 and those who did not give consent were excluded from the study. In all the subjects, detailed history was taken and thorough physical examination and appropriate laboratory investigations were done. Results: Acute hyperglycemia was associated with higher mortality (46.51% vs 9.09% P <0.001), higher levels of creatine phosphokinase MB (91.82±81.26 vs 18.11±14.78 P <0.001), troponin I (17.68±10.36 vs 4.10±2.68 P <0.001) and decreased left ventricular ejection fraction (48.72±5.99 vs 59.09±3.32 P <0.001), while no significant association was found with chronic hyperglycemia. Conclusions: Acute hyperglycemia was associated with higher in-hospital mortality, higher levels of cardiac biomarkers and decreased in left ventricular ejection fraction thereby suggesting larger infarct size as compared to chronic hyperglycemia.
Authors and Affiliations
Peter C L, P Saxena, P C Saxena, S Kumar, Smriti S
Keywords
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