THE CLINIC AND PATHOGENIC SIGNIFICANCE OF HYPERGLYCAEMIA DURING ACUTE MYOCARDIAL INFARCTION, 61

Abstract

Aim and methods: Hyperglycemia during acute myocardial infarction (AMI) is a risk factor for poor outcome and increased mortality.
Aiming to evaluate the frequency and the relationship between hyperglycemia and the evolution of patients with AMI, during in-hospital stay, the data from 347 AMI patients (214 men, 133 women) medical records, successively admitted to coronary care unit during an entire year, were analyzed.
According to fasting (FPG) and random plasma glucose (RPG) levels, the patients, besides those with previously known diabetes (KD; n=70), were classified as having “diabetic hyperglycemia” (DH; n= 81), “pre-diabetic hyperglycemia (PH; n=84) and normoglycemia (NG; n=78); Thirty four patients with only RPG but without FPG determination were not included in this classification.
Results: Together, KD, DH and PH groups accounted for 69% from the total.
The group with DH had the greatest mortality rate (29.6%; RR=4.6; p<0.001), followed by KD (18.6%; RR=2.9; p<0.03) and PH (13.1%; RR=2.4; p=0.15) as compared to NG (6.4%) group.
KD (41.3%±11.8; p<0.001), DH (43.3%±12.7; p<0.003) and PH (46.2%±9.9; p<0.03) groups had lower LVEF as compared to NG( 49.8% group).
A significant independent negative correlation between LVEF, FPG (r= -0.28; n=256; p<0.001), RPG (r= -0.273; n=256; p<0.001) and age (r= -0.22; n=256; p<0.001) was observed.
As compared to NG group, the prevalence of cardiac failure increased with increasing plasma glucose levels but the difference was significant only for DH (37.5% vs14.1%; RR=5.85; p<0.001).
Conclusion: The prevalence of glucose intolerance in our cohort of 347 hospitalized patients with AMI was 69%: 20.5 % with previously known diabetes and 48.7% with various degree of hyperglycemia.
Hyperglycemia, a frequent encounter during AMI is associated to risk of poor outcome and death.