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Blood glucose in acute coronary syndromes. How low should you go?

Hélia Martins1, Sílvia Monteiro1, Francisco Gonçalves1

  • 1Departamento de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Revista Espanola De Cardiologia (English Ed.)
|January 3, 2015
PubMed

Insights

High blood sugar on admission predicts long-term mortality in non-diabetic acute coronary syndrome patients. Glycemic variation during hospitalization further increases mortality risk, especially with severe hyperglycemia.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Hyperglycemia at hospital admission is linked to adverse outcomes in acute coronary syndrome (ACS) patients.
  • The impact of glycemic variability during hospitalization on long-term mortality in non-diabetic ACS patients remains less understood.

Purpose of the Study:

  • To investigate the association between glycemic variation during hospitalization and long-term all-cause mortality.
  • To assess hyperglycemia at admission as a predictor of mortality in non-diabetic ACS patients.

Main Methods:

  • Retrospective analysis of 2043 non-diabetic ACS patients.
  • Patients stratified by admission glucose quartiles (≤90, 90-140, 141-180, ≥181 mg/dL).
  • Mortality assessed based on glycemic variation above/below mean for each quartile over a median 1200-day follow-up.

Main Results:

  • All-cause mortality increased progressively with higher admission glucose quartiles (P=.007).
  • Admission hyperglycemia (≥181 mg/dL) independently predicted mortality (HR=1.74, P=.027).
  • In the highest glucose quartile, higher glycemic variation significantly increased mortality (37.5% vs 8.5%, P<.001).

Conclusions:

  • Admission hyperglycemia is a significant predictor of long-term mortality in non-diabetic ACS patients.
  • Increased glycemic variation during hospitalization exacerbates mortality risk.
  • Further research is warranted to validate these findings and explore interventions.
Abstract

Keywords:
Acute coronary syndromeAlteración del metabolismo de la glucosaGlucose dysmetabolismGlycemic variationHiperglucemia de estrésStress hyperglycemiaSíndrome coronario agudoVariación glucémica

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