The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock – Results from the CardShock Study

Kataja, Anu; Tarvasmäki, Tuukka; Lassus, Johan; Cardoso, José Carlos; Mebazaa, Alexandre; Køber, Lars; Sionís, Alessandro; Špinar, Jindřich; Carubelli, Valentina; Banaszewski, Marek; Marino, Rossella; Parissis, John; Nieminen, Markku S.; Harjola, Veli‐Pekka

doi:10.1016/j.ijcard.2016.10.033

Cited by 43 publications

(42 citation statements)

References 39 publications

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“…Patients with pronounced hyperglycaemia tended to have worse MI features, including an LAD culprit and worse LVEF. We did not, however, detect higher risk of adverse clinical outcomes in our patients with stress hyperglycaemia, as reported elsewhere, perhaps having to do with our exclusion of patients with cardiogenic shock . Still, patients with pronounced hyperglycaemia exhibited a significantly increased risk of adverse clinical events at follow‐up, as documented in other studies .…”

Section: Discussionsupporting

confidence: 54%

Hyperglycaemia, adverse outcomes and impact of intravenous insulin therapy in patients presenting with acute ST‐elevation myocardial infarction in a socioeconomically disadvantaged urban setting: The Montefiore STEMI Registry

Shitole

Srinivas

Berkowitz

et al. 2019

Endocrino Diabet & Metabol

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Background: Hyperglycaemia occurs frequently in ST-elevation myocardial infarction (STEMI) and is associated with poor outcomes, for which continuous insulin infusion therapy (CIIT) may be beneficial. Information is limited regarding hyperglycaemia in acute STEMI affecting urban minority populations, or how CIIT fares in such realworld settings. Methods and results:We assembled an acute STEMI registry at an inner-city health system, focusing on patients with initial blood glucose ≥180 mg/dL to determine the impact of CIIT vs usual care. Clinical and outcomes data were added through linkage to electronic records. Inverse-probability-of-treatment weighting using propensity scores (PS) was used to compare CIIT vs no CIIT. The 1067 patients included were mostly Hispanic or African American; 356 had blood glucose ≥180 mg/dL. Such pronounced hyperglycaemia was related to female sex, minority race-ethnicity and lower socioeconomic score, and associated with increased death and death or CVD readmission. CIIT was preferentially used in patients with marked hyperglycaemia and was associated with in-hospital hypoglycaemia (21% vs 11%, P = .019) and, after PS weighting, with increased in-hospital (RR 3.23, 95% CI 0.94, 11.06) and 1-year (RR 2.26, 95% CI 1.02, 4.98) mortality. No significant differences were observed for death at 30 days or throughout follow-up, or death and readmission at any time point. Conclusions:Pronounced hyperglycaemia was common and associated with adverse prognosis in this urban population. CIIT met with selective use and was associated with hypoglycaemia, together with increased mortality at specific time points. Given the burden of metabolic disease, particularly among race-ethnic minorities, assessing Units (CCU) of our two major sites, the Moses and Weiler divisions of MHS. The initial FS or venous blood glucose was obtained in the Emergency Room or Cardiac Catheterization Laboratory (CCL), and the benefits of CIIT is a prerogative that requires evaluation in large-scale randomized trials. K E Y W O R D Shyperglycaemia, outcomes, STEMI

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Section: Discussionsupporting

confidence: 54%

Hyperglycaemia, adverse outcomes and impact of intravenous insulin therapy in patients presenting with acute ST‐elevation myocardial infarction in a socioeconomically disadvantaged urban setting: The Montefiore STEMI Registry

Shitole

Srinivas

Berkowitz

et al. 2019

Endocrino Diabet & Metabol

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“…For every 18-mg/ dL increase in glucose level, there is a 4% increase in mortality in nondiabetic patients presenting with myocardial infarction [36]. Several studies showed that hyperglycemia during acute illness is associated with greater mortality in non diabetic patients than in those with documented diabetes [6,[37][38][39][40][41]. This might be explained by the fact that diabetic patients may have had more opportunity to adapt to a hyperglycemic milieu and therefore are less immediately affected by acute hyperglycemia than patients who are naive to elevated glucose levels.…”

Section: Discussionmentioning

confidence: 99%

Acute Hyperglycemia an Independent Risk Factor for Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI

Khorshid

Gomaa

Tamara

et al. 2017

JCCR

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“…In the present study, irrespective of DM, admission HGL was a significant predictor of IHD in AHF, but DM was not a predictor of IHD. Several studies also have shown that HGL is an independent predictor of IHD in patients with AHF [13][14][15][16]. Sud et al also showed that mildly elevated presentation blood glucose is associated with 30-day mortality and hospitalization in AHF patients with no pre-existing DM [16].…”

Section: Admission Hgl or Dm And Ihdmentioning

confidence: 99%

Admission Hyperglycemia as a Predictor of Mortality in Acute Heart Failure: Comparison between the Diabetics and Non-Diabetics

Cho

Kim

Lee

et al. 2020

JCM

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Background: To investigate the impact of admission hyperglycemia (HGL) on in-hospital death (IHD) and 1-year mortality in acute heart failure (AHF) patients with or without diabetes mellitus (DM). Methods: Among 5625 AHF patients enrolled in a nationwide registry, 5541 patients were divided into four groups based on the presence of admission HGL and diabetes mellitus (DM). Admission HGL was defined as admission glucose level > 200 mg/dL. IHD and 1-year mortality were compared. Results: IHD developed in 269 patients (4.9%), and 1-year death developed in 1220 patients (22.2%). DM was a significant predictor of 1-year death (24.8% in DM vs. 20.5% in non-DM, p < 0.001), but not for IHD. Interestingly, admission HGL was a significant predictor of both IHD (7.6% vs. 4.2%, p < 0.001) and 1-year death (26.2% vs. 21.3%, p = 0.001). Admission HGL was a significant predictor of IHD in both DM and non-DM group, whereas admission HGL was a significant predictor of 1-year death only in non-DM (27.8% vs. 19.9%, p = 0.003), but not in DM group. In multivariate analysis, admission HGL was an independent predictor of 1-year mortality in non-DM patients (HR 1.32, 95% CI 1.03–1.69, p = 0.030). Conclusion: Admission HGL was a significant predictor of IHD and 1-year death in patients with AHF, whereas DM was only a predictor of 1-year death. Admission HGL was an independent predictor of 1-year mortality in non-DM patients with AHF, but not in DM patients. Careful monitoring and intensive medical therapy should be considered in AHF patients with admission HGL, regardless of DM.

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The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock – Results from the CardShock Study

Cited by 43 publications

References 39 publications

Hyperglycaemia, adverse outcomes and impact of intravenous insulin therapy in patients presenting with acute ST‐elevation myocardial infarction in a socioeconomically disadvantaged urban setting: The Montefiore STEMI Registry

Hyperglycaemia, adverse outcomes and impact of intravenous insulin therapy in patients presenting with acute ST‐elevation myocardial infarction in a socioeconomically disadvantaged urban setting: The Montefiore STEMI Registry

Acute Hyperglycemia an Independent Risk Factor for Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI

Admission Hyperglycemia as a Predictor of Mortality in Acute Heart Failure: Comparison between the Diabetics and Non-Diabetics

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