Predictors of stress hyperglycemia in patients with acute phase of Q-wave myocardial infarction complicated by acute heart failure without diabetes history
DOI:
https://doi.org/10.14739/2310-1210.2018.3.130809Keywords:
Q myocardial infarction, acute heart failure, hyperglycemiaAbstract
The aim was to identify the predictors of stress hyperglycemia in patients with acute phase of Q-wave myocardial infarction complicated by acute heart failure without diabetes history.
Materials and methods. 55 patients in acute phase of Q-wave myocardial infarction complicated by acute heart failure were examined. 38 (67 %) of them were male. The average age was 63 ± 10.6 years. Stress hyperglycemia was revealed in 32 persons on admission. The average level of glucose in patients with hyperglycemia was 9.25 ± 0.35 mmol/l, with normoglycemia – 6.05 ± 0.23 mmol/l. When constructing the multivariate linear regression model we used the data from anamnesis and body mass index calculation. Diabetes mellitus in past history and diabetes mellitus first-diagnosed on further patient’s examination were the exclusion criteria.
Results. Three reliable risk factors in the construction of multivariate linear regression model were identified: male, body mass index and history of rhythm disorders. With increasing body mass index by 10g/m2 the levels of glycemia increased by 2.1 mmol/l, glucose level in men was higher than in women by 1.4 mmol/l and the past history of rhythm disorders increased the level of glucose by 3.01 mmol/l. The coefficient of determination (R-squared) was 0.95, which confirmed the high quality of the model. Body mass index was determined to have the greatest impact, using coefficient of elasticity (e = 0.727). The increase of 1% in body mass index led to increase in glucose level by an average of 0.73 %. The relative risk of stress hyperglycemia in patients with a past history of rhythm disorders was 2.94 (95 % CI 1,77–4,88), P ≤ 0.05.
Conclusions. In patients with the acute phase of Q-wave myocardial infarction, complicated by acute heart failure, the predictors of stress hyperglycemia development were the body mass index, male and past history of rhythm disorders. In patients with history of rhythm disorders the relative risk of stress hyperglycemia was 2.94 times higher than in persons without history of rhythm disorders.
References
Dedov, I. I., Mel'nichenko, G. A. (2009) E'ndokrinologiya. Nacional'noe rukovodstvo [Endocrinology. National leadership]. Moscow: Ge'otar-medicina. [in Russian].
Klypa, T. V., Orehova, M. S., & Zabrosaeva, L. I. (2015) Giperglikemiya kriticheskikh sostoyanj [Hyperglycaemia in criticaly ill patients]. Sakharnyj diabet, 18(1), 33–41. [in Russian]. doi: 10.14341/DM2015133-41.
Pittas, A. G., Siegel, R. D., & Lau, J. (2006) Insulin therapy and in-hospital mortality in critically ill patients: systematic review and meta-analysis of randomized controlled trials. Journal of parenteral and enteral nutrition, 30(2), 164–172. doi: 10.1177/0148607106030002164.
Preiser, J. C. (2013) Glucose control. World review of nutrition and dietetics, 105, 82–89. doi: 10.1159/000341275.
Younk, L. M., Lamos, E. M., & Davis, S. N. (2014) The cardiovascular effects of insulin. Expert opinion on drug safety, 13(7), 955–966. doi: 10.1517/14740338.2014.919256.
Moghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., et al. (2009) American association of clinical endocrinologists and american diabetes association consensus statement on inpatient glycemic control. Diabetes Care, 32(6), 1119–1131. doi: 10.2337/dc09-9029.
Amr, A. Y., & Heba, M. E. (2017) Predictive Value Of Admission Blood Glucose Level In Patients With Acute Myocardial Infarction, ClinicalTrials.gov. Retrieved from https://clinicaltrials.gov/ct2/show/NCT03164707.
Sun, C., Qin, F., Zhao, Y., Bai, F., Liu, N., Liu Z., & Liu, Q. (2018) Could the stress hyperglycemia ratio predict the clinical outcomes of coronary artery disease patients after percutaneous coronary intervention? International Journal of Cardiology, 254, 343. doi: 10.1016/j.ijcard.2017.07.030.
Shah, B., Amoroso, N. S., & Sedlis, S. P. (2012) Hyperglycemia in nondiabetic patients presenting with acute myocardial infarction. Am J Med Sci, 343(4), 321–326. doi: 10.1097/MAJ.0b013e31822fb423.
Teraguchi, I., Imanishi, T., Ozaki, Y., Tanimoto, T., Kitabata, H., Ino, Y., et al. (2012) Impact of stress hyperglycemia on myocardial salvage following successfully recanalized primary acute myocardial infarction. Circ J, 76(11), 2690–2696.
Fathy, M., Ghanem, Y., Sadaka, M., & El-Karim, A. A. (2016) Stress Hyperglycemia as a Prognostic Indicator in Non-Diabetic ST Elevation Myocardial Infarction Patients, Journal of Medical Science And clinical Research., 4(1). doi: http://dx.doi.org/10.18535/jmscr/v4i1.18.
Kerby, J. D., Griffin, R. L., MacLennan, P., & Rue, L. W. 3rd. (2012) Stress-induced hyperglycemia, not diabetic hyperglycemia, is associated with higher mortality in trauma. Ann Surg, 256, 446–452. doi: 10.1097/SLA.0b013e3182654549.
Koval', M. (2008) Giperglikemiya pri OKS. Nauchnoe soglashenie ANA [Hyperglycemia in ACS. AHA Science Agreement]. Medicine Review, 4(4), 51–55. [in Russian].
Gard, R., Grover, A., McGurk, S., & Rawn, J. D. (2013) Predictors of hyperglycemia after cardiac surgery in nondiabetic patients. The Journal of Thoracic and Cardiovascular Surgery, 145, 1083–1087. doi: 10.1016/j.jtcvs.2012.07.089.
Bayar, Q. (2016) Stress hyperglycemia in acute coronary syndrome and pulmonary disease. 18th European Congress of Endocrinology 2016. Munich, Germany. Endocrine Abstracts, 41. doi: 10.1530/endoabs.41.EP245.
Ladeira, R. T., Baracioli, L. M., Faulin, T. E., Abdalla, D. S., Seydell, T. M., Maranhão, R. C., et al. (2013) Unrecognized diabetes and myocardial necrosis: predictors of hyperglycemia in myocardial infarction. Arq Bras Cardiol, 100(5), 404–411. doi:10.1590/S0066-782X2013005000025.
Mirghani, H. O., Mohammed, O. S., & Alyoussuf, A. A. (2015) Stress Hyperglycemia and its Relation to Acute Coronary Syndrome Complications. Fam Med Med Sci Res, 4(4), 182.
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