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Stress hyperglycemia in acute ST-segment elevation myocardial infarction is a marker of left ventricular remodeling

Danijela Djordjevic-Radojkovic1, Goran Koracevic, Dragana Stanojevic

  • 1Clinic for cardiovascular diseases, Clinical Center, Nis, Serbia.

Acute Cardiac Care
|June 7, 2013
PubMed

Insights

Stress hyperglycemia (SH) in ST-elevation myocardial infarction (STEMI) significantly increases in-hospital mortality risk. SH may also indicate left ventricular (LV) remodeling one year post-STEMI.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Stress hyperglycemia (SH) in ST-elevation myocardial infarction (STEMI) is linked to increased in-hospital mortality.
  • The role of SH as a predictor of long-term post-hospital risk and left ventricular (LV) remodeling remains debated.

Purpose of the Study:

  • To evaluate the in-hospital and one-year risks associated with SH in STEMI patients.
  • To determine if SH serves as a marker for LV remodeling post-STEMI.

Main Methods:

  • A cohort of 275 STEMI patients undergoing reperfusion therapy was analyzed.
  • Patients were stratified into three groups: pre-existing diabetes mellitus (DM), SH without DM, and neither DM nor SH.
  • SH was defined as admission blood glucose ≥ 8 mmol/l.

Main Results:

  • In-hospital mortality was highest in the SH without DM group (9.3%) compared to DM (5%) and control (1.6%) groups (P < 0.05).
  • For patients without known DM, SH was associated with a 6.378-fold increase in in-hospital mortality.
  • End-diastolic volume (EDV) significantly increased in the SH without DM group over one year (126 ± 37 to 145 ± 30 ml, P < 0.05), suggesting LV remodeling.

Conclusions:

  • SH in STEMI patients is a significant predictor of high in-hospital mortality.
  • SH may serve as a marker for adverse LV remodeling, evidenced by increased EDV over one year.
Abstract

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