Related Experiment Videos

Prognostic implications of stress hyperglycemia in acute ST elevation myocardial infarction. Prospective

Rafael Sanjuán1, Julio Núñez, M Luisa Blasco

  • 1Unidad Coronaria, Hospital Clínico Universitario, Valencia, España. sanjuan_raf@gva.es

Revista Espanola De Cardiologia
|February 19, 2011
PubMed

Insights

Stress hyperglycemia, indicated by elevated blood glucose levels on admission, significantly increases the risk of in-hospital mortality and arrhythmias in patients with ST-segment elevation myocardial infarction (STEMI). This finding aids in risk stratification for STEMI patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Elevated plasma glucose in acute myocardial infarction (MI) correlates with adverse outcomes.
  • Stress hyperglycemia is a common finding in acute cardiac events.

Purpose of the Study:

  • To investigate the association between stress hyperglycemia and in-hospital mortality in ST-segment elevation myocardial infarction (STEMI) patients.
  • To determine if admission glucose levels can predict mortality and arrhythmias in STEMI.

Main Methods:

  • Analysis of 834 consecutive STEMI patients admitted to a Coronary Care Unit.
  • Cox regression analysis to assess the association between admission glucose and mortality.
  • Receiver Operating Characteristic (ROC) curves to determine optimal glucose threshold.

Main Results:

  • An admission glucose level of ≥140 mg/dl was identified as a predictor of mortality.
  • Patients with glucose ≥140 mg/dl had higher rates of malignant ventricular tachyarrhythmias, bundle branch block, atrioventricular block, and in-hospital mortality (15% vs. 5%).
  • Multivariate analysis revealed a 2-fold increased risk of in-hospital mortality (95% CI: 1.2-3.5) irrespective of diabetes status.

Conclusions:

  • Stress hyperglycemia on admission is a significant predictor of mortality and arrhythmias in STEMI patients.
  • Admission glucose levels can be utilized for risk stratification in STEMI patients.
  • Early identification of hyperglycemia may guide therapeutic interventions to improve outcomes.
Abstract

Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Psychoneuroimmunology: Diabetes and Cancer01:19

Psychoneuroimmunology: Diabetes and Cancer

Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Exercise Stress Test01:26

Exercise Stress Test

Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...