Prevalência e influência da hiperglicemia de estresse no prognóstico em uma coorte de pacientes com síndrome coronariana aguda

Abstract

ObjectiveTo demonstrate the prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome and to determine the correlation of stress hyperglycemia with death, heart failure and/or left ventricular systolic dysfunction during the intrahospital phase. MethodsA prospective initial cohort study of hospitalized patients with acute coronary syndrome with or without ST segment elevation. The groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular events. The chi-square test or Fisher's exact test and student's t-test were used to compare the groups with and without stress hyperglycemia. The variables with p<0.20 in the univariate analysis were submitted to logistic regression. ResultsIn total, 363 patients with an average age of 12.45 ± 62.06 were studied. There was a predominance of males (64.2%). In total, 96 patients (26.4%) presented with stress hyperglycemia. There were no differences between the groups with or without stress hyperglycemia. The area under the ROC curve was 0.67 for the relationship between stress hyperglycemia and the composite outcome heart failure, left ventricular systolic dysfunction or death at the end of the hospital admission. The ROC curve proved that stress hyperglycemia was the predictor of the composite outcome (death, heart failure and/or ventricular dysfunction). The multivariate analysis did not indicate age, stress hyperglycemia or admission heart rate as risk factors. ConclusionStress hyperglycemia was common in the studied sample. In the univariate analysis, the presence of stress hyperglycemia was associated with such events as death, heart failure and/or intrahospital ventricular dysfunction in patients with acute coronary syndrome.

Study of Stress Hyperglycemia as an in-Hospital Prognostic Factor in Acute St Elevation Myocardial Infarction Patients

“…[24,25] In the Nazli Gormeli Kurt [26] investigation, it was discovered that 141 (45.9%) of the patients had stress hyperglycemia. In the Renata de Faria Modenesi study [27], 96 patients (26.4%) had stress hyperglycemia. [4] In research by Marfella et al [28], 31 (29%) individuals had stress hyperglycemia.…”

Conhecimento da equipe de enfermagem nas complicações do diabetes mellitus em emergência

“…According to the literature, altered levels of consciousness can occur both in hypoglycemia and in diabetic ketoacidosis. (1,(5)(6)(7)(8)(9)(10)(11) Five nurses mentioned altered mental status as important, and of these, three emphasized it as a sign of severity.…”

Diabetes mellitus e alterações da glicemia em pacientes com desfecho desfavorável admitidos em unidade de terapia intensiva

“…7 Esses estudos revelaram que parte considerável dos pacientes em UTI teria hiperglicemia de estresse, entidade associada ao estímulo adrenérgico provocado pelo estresse metabólico ao qual o paciente está submetido. 19 Esse tipo particular de hiperglicemia, a qual ocorre durante uma doença aguda grave, provavelmente tem um mecanismo aumento da glicemia em pacientes com DM tipo 1 e 2. Além disso, pacientes com diagnóstico prévio de DM podem ser acometidos por doença aguda grave e, como consequência, desenvolverem hiperglicemia de estresse, a qual se apresentaria como uma deterioração nos níveis glicêmicos basais previamente associados ao DM.…”