Prevalence and prognostic impact of stress-induced hyperglycemia in patients with acute type A aortic dissection

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Shuai Liu1, Chenxi Song1, Kongyong Cui1

  • 1Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China.

Diabetes Research and Clinical Practice
|July 7, 2023
PubMed

Insights

Nearly 40% of acute type A aortic dissection patients without diabetes exhibit stress-induced hyperglycemia (SIH). Severe SIH is linked to higher mortality, indicating its role as a disease severity predictor.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Surgery

Background:

  • Acute type A aortic dissection (ATAAD) is a life-threatening condition.
  • Stress-induced hyperglycemia (SIH) may impact outcomes in critically ill patients.
  • The prevalence and prognostic significance of SIH in non-diabetic ATAAD patients remain unclear.

Purpose of the Study:

  • To determine the prevalence of SIH in patients with ATAAD without pre-existing diabetes.
  • To investigate the association between SIH and short-term and long-term clinical outcomes in ATAAD patients.

Main Methods:

  • A cohort of 1098 ATAAD patients without diabetes was analyzed.
  • Patients were stratified into normoglycemia, mild-to-moderate SIH (7.8–11.1 mmol/L), and severe SIH (≥11.1 mmol/L) groups based on admission blood glucose.
  • Multivariate regression analysis assessed the relationship between SIH and mortality risk.

Main Results:

  • SIH was present in 38.3% of ATAAD patients (mild-to-moderate: 32.9%; severe: 5.46%).
  • SIH patients had a higher proportion of high-risk clinical manifestations and received more conservative treatment.
  • Severe SIH independently predicted increased 30-day (OR: 3.773) and 1-year mortality (OR: 3.522).

Conclusions:

  • Approximately 40% of non-diabetic ATAAD patients experience SIH.
  • SIH is associated with high-risk features and non-surgical management.
  • Severe SIH serves as an independent predictor of mortality and reflects ATAAD disease severity.
Abstract

Keywords:
ATAADMortalityStress hyperglycemia

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