心血管疾病与诊断

Association between Admission Serum Blood Glucose Levels and 30-Day Mortality in Patients Presenting with ST Elevation Myocardial Infarction

Abstract

Patted SV, Porwal SC, Ambar S, Prasad MR, Sethi K, Hesarur V, Patil V and Atharga S

Objectives: The aim of the study was to evaluate the association between stress hyperglycaemia and in hospital and 30-day mortality in patients with acute ST elevation myocardial infarction (STEMI).

Materials and methods: This one-year hospital based cross sectional study was performed in the Department of Cardiology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2017 to December 2018. A total of 465 patients with STEMI were evaluated for ad-mission blood glucose levels and outcome.

Results: Out of 465 patients, 255 (54.84%) patients had elevated admission blood sugar levels (≥ 140 mg/dL). A total of 47 patients (10.10%) died out of which 34 died during hospitalization. Those who presented with serum blood glucose levels of more than 140 mg/dL had an advanced Killip class and a poorer outcome. Mortality was significantly higher in patients with admission blood glucose levels of >200 mg/dL (15.28% vs. 8.11% with 140 to 200 mg/dL and 7.62% with <140 mg/dL; p=0.046) irrespective of the diabetic status and the mean blood sugar level in patients who expired was significantly higher (227.09 ± 131.53 vs. 178.83 ± 96.02 g/dL; p=0.018). Also, non survivors had a greater degree of left ventricular dysfunction (40.11 ± 5.56 vs. 43.70 ± 4.61%; p<0.001) and lower mean systolic blood pressure (96.36 ± 30.75 vs. 123.17 ± 27.56 mm Hg; p<0.001) in comparison to survivors.

Conclusion: Based on univariate analysis stress hyperglycaemia on admission is a predictor of mortality and could be used in stratification of risk in patients with Acute STEMI.