Hyperglycemia and risk of ventricular tachycardia among patients hospitalized with acute myocardial infarction

Abstract

BackgroundLittle is known about the association of hyperglycemia with the development of ventricular tachycardia (VT) in patients hospitalized with acute myocardial infarction (AMI) which we examined in the present study. The objectives of this community-wide observational study were to examine the relation between elevated serum glucose levels at the time of hospital admission for AMI and occurrence of VT, and time of occurrence of VT, during the patient’s acute hospitalization.MethodsWe used data from a population-based study of patients hospitalized with AMI at all central Massachusetts medical centers between 2001 and 2011. Hyperglycemia was defined as a serum glucose level ≥ 140 mg/dl at the time of hospital admission. The development of VT was identified from physicians notes and electrocardiographic findings by our trained team of data abstractors.ResultsThe average age of the study population was 70 years, 58.0% were men, and 92.7% were non-Hispanic whites. The mean and median serum glucose levels at the time of hospital admission were 171.4 mg/dl and 143.0, respectively. Hyperglycemia was present in 51.9% of patients at the time of hospital admission; VT occurred in 652 patients (15.8%), and two-thirds of these episodes occurred during the first 48 h after hospital admission (early VT). After multivariable adjustment, patients with hyperglycemia were at increased risk for developing VT (adjusted OR = 1.48, 95% CI = 1.23–1.78). The presence of hyperglycemia was significantly associated with early (multivariable adjusted OR = 1.39, 95% CI = 1.11–1.73) but not with late VT. Similar associations were observed in patients with and without diabetes and in patients with and without ST-segment elevation AMI.ConclusionsEfforts should be made to closely monitor and treat patients who develop hyperglycemia, especially early after hospital admission, to reduce their risk of VT.

Effects of empagliflozin versus placebo on cardiac sympathetic activity in acute myocardial infarction patients with type 2 diabetes mellitus: the EMBODY trial

“…Glycemic variability is associated with cardiovascular autonomic neuropathy [41,42], and hyperglycemia results in ventricular tachycardia in patients hospitalized with AMI [43]. Moreover, the presence of T2DM without AMI is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission [44].…”

Effects of empagliflozin versus placebo on cardiac sympathetic activity in acute myocardial infarction patients with type 2 diabetes mellitus: the EMBODY trial

“…Glycemic variability is associated with cardiovascular autonomic neuropathy [41,42], and hyperglycemia results in ventricular tachycardia in patients hospitalized with AMI [43]. Moreover, the presence of T2DM…”

High admission glucose levels predict worse short-term clinical outcome in non-diabetic patients with acute myocardial infraction: a retrospective observational study

“…In a previous study, in patients with AHG, the proportion of low TIMI flow scores was higher than that in patients with normal blood glucose levels after PCI [16]. Infarct size was larger [17], and the incidence rates of malignant arrhythmia [18] and cardiac shock [19] were also higher in patients with AHG, especially in non-DM patients than in those without AHG [16]. In the current study, CK-MB, cardiac troponin I, and MYO levels were higher in the severe hyperglycemia group of non-DM patients with AMI.…”