medigraphic.com
ISSN 1561-302X (Print)

2018, Number 2

<< Back Next >>

Rev cubana med 2018; 57 (2)

Prognostic value of glycemia´s disorders in congestive heart failure

Buchaca FEF, Camargo SHH, Tamargo BTO, Rodríguez AL

Language: Spanish
References: 27
Page: 1-11
PDF size: 173.37 Kb.


ABSTRACT

Introduction: There are scanty evidences that glycemia can be used for predicting the complications of congestive heart failure (CHF). For this reason, it was decided to measure the glycemia values of patients with CHF in several moments of their admission.
Objective: To identify the prognostic value of glycemia´s disorders in the appearance of complications of the congestive heart failure.
Methods: There were included the patients admitted due to congestive heart failure between 2013 and 2015, who met with Framingham's criteria and had not been under hyperglycaemic treatments nor presenting a terminal illness. Their glycemia was quantified in the admission moment, also the following day in fasting and postprandial, and of being altered a glusocilada hemoglobin´s test was performed to determine if they were diabetics previously. Association between the glycemia and in-hospital complications was looked-up.
Results: 111 patients were studied, finding as more frequent complications electrolytic disorders, death, shocks and pulmonary oedema; the pathological background did not have influence in the appearance of complications. There was an association between the in-hospital hyperglycaemia (p=0.032) and the hyperglycaemia due to stress (p=0.035) with the presence of complications, being the posprandial hyperglycaemia the one that showed an independent influence in the above mentioned clinical evolution (p=0.037).
Conclusions: There was found a high frequency of hyperglycaemia in the admission moment, as well as basal and postprandial hyperglycaemia; and an association between the in-hospital hyperglycemia and the possibility of complications during the periods of worsening of the CHF.


REFERENCES

  1. Mebazaa A, Gayat E, Lassus J, Meas T, Mueller C, Maggioni A, et al. Association between elevated blood glucose and outcome in acute heart failure. Journal of American College of Cardiology. 2013;61:820-9.

  2. Perna E. Utilidad de los marcadores serológicos en el diagnóstico y estratificación de riesgo de la insuficiencia cardíaca. Blood. 2007;2:55-61.

  3. Swan JW, Anker SD, Walton C, Godsland IF, Clark AL, Leyva F, et al. Insulin resistance in chronic heart failure: relation to severity and etiology of heart failure. J Am Coll Cardiol. 1997;30(2):527-32.

  4. Suskin N, McKelvie R, Burns R, Latini R. Pericak D, Probstfield J, et al. Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure. European Heart Journal. 2000;21:1368-75.

  5. Barsheshet A, Garty M, Grossman E, Sandach A, Lewis BS, Gottlieb S, et al. Admission blood glucose level and mortality among hospitalized nondiabetic patients with heart failure. Arch Intern Med. 2006;166(15):1613-9.

  6. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin the rapy in critically ill patients. N Engl J Med. 2001;345(19):1359-67.

  7. Mckee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: The Framingham study. N Eng J of Med. 1971;285(26):1441-6.

  8. Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353-69.

  9. McMurray JV, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2012;33:1787-847. Disponible en: https://doi.org/10.1093/eurheartj/ehs104

  10. Thakker U, Ellman T, Magleby R. The impact of acute illness on (HbA1c) determination of undiagnosed diabetes. Diabetes Metab Res Rev. 2012;28(7):603-7.

  11. Malcolm JC, Kocourek J, Keely E, Feibel R, Brez S, Forster AJ, et al. Implementation of a screening program to detect previously undiagnosed dysglycemia in hospitalized patients. Canadian J Diabetes. 2015;38:79-84.

  12. Pasquel FJ, Gomez-Huelgas R, Anzola I, Oyedokun F, Haw JS, Vellanki P, et al. Predictive value of admission hemoglobin A1C on inpatient glycemic control and response to insulin therapy in medicine and surgery patients with type 2 diabetes. Diabetes Care. 2015;38(12):202-3.

  13. Bagshaw SM, Bellomo R, Jacka MJ, Egi M, Hart GK, George C. The impact of early hypoglycemia and blood glucose variability on outcome in critical illness. Critical Care. 2009;13:1-10.

  14. Nishikawa T, Edelstein D, Du XL. Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature. 2000;404:787-90.

  15. Tan KC, Chow WS, Ai VH. Advanced glycation end products and endothelial dysfunction in type 2 diabetes. Diabetes Care. 2002;25:1055-9.

  16. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia and increased risk of death after myocardial infartion in patients with and without diabetes: a systematic overview. Lancet. 2000;355:773-8.

  17. Leonidou L, Mouzaki A, Michalaki M, De Lastic AL, Kyriazopoulou V, Bassaris HP, et al. Cytokine production and hospital mortality in patients with sepsis-induced stress hyperglycemia. J Infect. 2007;55:340-6.

  18. García Y, Licea Puig ME, García Cardoso F, Álvarez Delgado Y, Barnés Domínguez JA, Almaguer García S, et al. Control glucémico en el proceso perioperatorio de los pacientes con diabetes mellitus. Rev Cubana Endocrinología. 2012 [citado 27 ago 2013];23(1):62-75. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid =S1561295320 12000100006&lng=es

  19. Anderson RE, Tan WK, Mertin HS, Meyer FB. Effects of glucose and PaO2 modulation on cortical intracellular acidosis, NADH redox state and infarction in the ischaemic penumbra. Stroke. 1999;30:160-70.

  20. Buchaca E, Castillo F, Rodríguez L, Fernández F, Bermúdez S, Gutiérrez A, et al. La glucemia de ayuno como indicador pronóstico durante las complicaciones macrovasculares agudas. Rev Cubana Med. 2011;50(4):415-25.

  21. Miguel-Yanes JM, Gonzalo-Hernando C, Muñoz N, Méndez M, Cava F, Torres J. First plasma glucose value after urgent admission and in hospital mortality in acutely decompensated heart failure. Heart Lung. 2015;44:137-40.

  22. Lazzeri C, Valente S, Gensini F. Hyperglycemia in acute heart failure: An opportunity to intervene? Curr Heart Fail Rep. 2014;11:241-5.

  23. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl. 1):144-151. Disponible en: https://doi.org/10.2337/dc18-S014

  24. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. EMPAREG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117-28.

  25. Fitchett D, Butler J, Van de Borne P. Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME trial. Eur Heart J. 2017 [citado 29 sept 2017]. Disponible en: https://academic.oup.com/eurheartj/article/doi/10.1093/eurheartj/ehx511/409634 5/Effects-of-empagliflozinon-risk-for

  26. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. CANVAS Program Collaborative Group. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377:644-57.

  27. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes 2018.American Diabetes Association. Diabetes Care. 2018;41(Suppl.1):S86-S104. Disponible en: https://doi.org/10.2337/dc18-S009




2020     |     www.medigraphic.com