Prognostic value of stress hyperglycemia in acute coronary syndrome in non-diabetic patients

Abstract

Background: Any kind of stress, physical or emotional leads to increased production of ACTH, thus leading to increased glucocorticoid release and hence, hyperglycemia. Various studies suggest that the treatment of Stress Hyperglycemia has tremendous potential to reduce the morbidity and mortality among hospitalized patients with Stress Hyperglycemia. Aims: To study the prevalence and prognostic value of stress hyperglycemia in determining the cardiovascular outcome in non-diabetic acute coronary syndrome patients. Material and Methods: This study was conducted in 100 patients with no previous history of diabetes with Acute Coronary Syndrome over a period of 18 months. Stress Hyperglycemia in the acute phase of Acute Coronary Syndrome was defined as random blood glucose levels greater than or equal to 140 mg/dl. Patients were divided into two groups A and B on the basis of random blood sugar as normoglycemics and those with Stress Hyperglycemia, respectively. These groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular outcome of heart failure, arrhythmias, cardiogenic shock or death. The data was collected and statistically analysed. Results: Out of 100 patients of acute coronary syndrome with no previous history of diabetes, 38 % were found to be having stress hyperglycemia. Heart failure, arrhythmia, shock and death occurred in 57.89%,13.16 % 13.16 %, 21.05% of Stress Hyperglycemic patients as compared to only 16.12%,4.83%, 8.06 %, 6.45 % in normoglycemic patients, respectively. Summary and Conclusion: There is high prevalence (38%) of Stress Hyperglycemia in Acute coronary syndrome patients and is associated with adverse outcomes such as heart failure, arrhythmia, cardiogenic shock and death.

A Study on Glycaemic Status Impact in Acute Coronary Syndrome

“…In another study [19] conducted in 100 patients with no previous history of diabetes with ACS to demonstrate the correlation between stress hyperglycaemia and cardiovascular outcome of heart failure, arrhythmias, cardiogenic shock or death. There was high prevalence (38%) of stress hyperglycaemia in ACS patients even among non-diabetics when compared to normoglycemic group had higher incidence of MACE.…”