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2013, Number 2

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Rev Cubana Cardiol Cir Cardiovasc 2013; 19 (2)

Hyperglycemia, prognosis marker of adverse events in heart attack

García CY, González RCM, Jorrín RFR, Valladares CFJ, Navarro LJJ, Castillo FS

Language: Spanish
References: 16
Page: 72-78
PDF size: 368.45 Kb.


ABSTRACT

Introduction: Hyperglycemia on admission in patient with acute coronary syndrome is common, considered bad marker of clinical evolution and death.
Objective: To value the use of admission glycemia like prognosis factor of adverse events in patient with heart attack.
Method: Descriptive study and longitudinal prospective. 246 patients were included with heart attack admitted in Cienfuegos hospital and their evolution was continued during 30 days. It was determined as point of a very best cut for the mortality at admission glycemia ≥ 7,1mmol/l by means of the curve ROC and one carries out analysis logistics regression to identify independent predictors of death.
Results: The patients with glycemia ≥ 7,1mmol/l prevailed the diabetes, tachycardia, killip≥II, inferior localization, small ejection fraction and bigger incidence of adverse events (60% versus 2%, p=0,000) as heart failure(30% versus 15%; p = 0,001), malign ventricular arrhythmias (23% versus 4%; p = 0,000) and death(15% versus 3%; p = 0,001), with smaller survival regarding the patients with glycemia ‹7,1mmol/l(85,5% in contrast with 96,6%). Age and ejection fraction were independent predictors of death in the multivariate analysis.
Conclusions: In patient with myocardial infarction the hyperglycemia to the entrance, with a cut point ≥7,1mmol/l, predicts a short term increment of adverse events, although it was not independent predictor of death.


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