Stress Hyperglycemia as a Prognostic Indicator in Non-Diabetic ST Elevation Myocardial Infarction Patients

Title: Stress Hyperglycemia as a Prognostic Indicator in Non-Diabetic ST Elevation Myocardial Infarction Patients

Authors:Dr Mohamed Fathy, Prof Yehia Ghanem , Prof Mohamed Sadaka, Prof Azza Abd El-Karim

DOI: http://dx.doi.org/10.18535/jmscr/v4i1.18

Abstract

Patients either with or without a prior history of diabetes mellitus may present with hyperglycemia during acute myocardial infarction (AMI); it is uncertain whether hyperglycemia upon admission, irrespective of the diagnosis of diabetes, remains an independent predictor of in-hospital morbidity and mortality.

Aim of the study

We aimed in this study to assess the impact of admission blood glucose level on the hospital course and outcome in non diabetic patients presenting with STEMI

Patients and methods

We included 100 non diabetic patients with STEMII divided into two groups: group I included 45 patients with admission blood glucose level less than 180 mg/dl and group II included 55 patients with admission blood glucose level 180 mg/dl or more. All patients were subjected to complete history taking and complete clinical examination; 12-lead ECG was performed for every patient and routine laboratory investigations including cardiac enzymes, admission blood glucose level, and HbA1c were estimated at the time of admission of the patients.

Results

There was significant correlation between admission blood glucose level and history of smoking . There was also significant correlation between admission blood glucose level and complications of myocardial infarction including sinus tachycardia, arrhythmia, and ICU length of stay . However, HbA1c level was not found to be correlated with any of the previous parameters.

Conclusion

We concluded that elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with AMIs. However, the prognostic value of diabetic control (i.e. hemoglobin A1c levels) in patients with AMI is still undefined.

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Corresponding Author

Dr Mohamed Fathy