Diagnostic and prognostic role of hyperglycemia in acute phase of myocardial infarction

Abstract

Aim. To study diagnostic and prognostic role of hyperglycemia in patients with acute phase of myocardial infarction (MI), according to five-year follow(up results. Material and methods. In total, 130 men aged 47,1±1,7 years were examined. In 75 patients, glucose level in venous blood was measured during acute MI phase, one week later, and after 21-26 days. Five(year follow-up data were available for 85,3% of the participants. Results. All patients were divided into two clinical groups (cG), according to glucose level in acute MI phase: cG I (n=43) and cG II (n=32), with glucose levels of 4,74±0,85 mM/l and 8,35±2,50 mM/l, respectively (p<0,00001). Five(year death rates in cG II and cG I were 66,6% and 48,6%, respectively (x2=2,79; p>0,05). Among patients with adverse outcomes, individuals with hypoglycemia during acute MI phase were prevalent (14,3% vs 7,1% in cG I). Maximal five(year survival was associated with isoglycemia and/or mild hyperglycemia. In patients with glucose level >7 mM/l, death HR was 1,56 (CI 1,14:3,46; p<0,05). For hypoglycaemia (<3,9 mM/l), death HR was maximal - 1,74 (CI 1,14:3,46; p<0,05). Conclusion. In acute MI phase, transitory hyperglycemia was registered in 44,4% of the patients, hypoglycemia – in 11,3%, and isoglycemia – in 44,3%. Hyper- and hypoglycemia were associated with aggravated clinical course, structural and metabolic myocardial disturbances, and adverse prognosis.

Keywords

• myocardial infarction
• hyperglycemia
• diagnostic value
• prognosis