Key result
On-arrival high blood glucose (>140 mg/dL) in acute coronary syndrome was independently associated with increased hospitalization adverse events (adjusted OR 2.3; 95% CI 1.1-4.9; P=0.03).
Why the study?
Does high blood glucose on arrival increase the risk of hospitalization adverse events and mortality in Javanese patients with acute coronary syndrome?
Cohort (n=148)
Does high blood glucose on arrival increase the risk of hospitalization adverse events and mortality in Javanese patients with acute coronary syndrome?
Elevated blood glucose on arrival in patients with acute coronary syndrome is strongly and independently associated with increased in-hospital mortality and adverse hemodynamic events.
BACKGROUND: High blood glucose level is frequently encountered in acute coronary syndrome. We investigated the effects of high blood glucose measured on arrival on hospitalization adverse events in acute coronary syndrome. Our study patients were Javanese in ethnicity, which constitute half of population in Indonesia. We hypothesized that elevated blood glucose has detrimental effects on hospitalization for acute coronary syndrome. METHODS: We designed an observasional cohort study and recruited 148 consecutive patients with acute coronary syndrome. Venous blood was collected on hospital arrival. High blood glucose level was determined as plasma glucose > 140 mg/dL. Adverse hospitalization events were recorded, i.e. mortality, acute heart failure, cardiogenic shock and heart rhythm disorders. Echocardiography examination was performed to determine left ventricular function. RESULTS: The prevalence of on arrival high blood glucose among Javanese patients with acute coronary syndrome was considerably high (36%). On arrival high blood glucose was associated with acute heart failure (P < 0.001) and shock cardiogenic (P = 0.02). Heart rhythm disorders were higher in high blood glucose patients (P = 0.004). Left ventricular dysfunction was more prevalent in high blood glucose patients (P = 0.001) and ejection fraction was lower (P = 0.001). On arrival high blood glucose was independently associated with hospitalization adverse events (adjusted odds ratio = 2.3, 95% confidence interval: 1.1-4.9, P = 0.03) and hospital mortality (adjusted odds ratio = 6.9, 95% confidence interval: 1.2-38.6, P = 0.03). CONCLUSIONS: Our study suggests that on arrival high blood glucose among Javanese patients with acute coronary syndrome is considerably high and is associated with detrimental and fatal hospitalization outcomes.
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Hartopo (2011) conducted a cohort in Acute coronary syndrome (n=148). High blood glucose on arrival (> 140 mg/dL) vs. Blood glucose ≤ 140 mg/dL was evaluated on Hospitalization adverse events (adjusted OR 2.3, 95% CI 1.1-4.9, p=0.03). On-arrival high blood glucose (>140 mg/dL) in acute coronary syndrome was independently associated with increased hospitalization adverse events (adjusted OR 2.3; 95% CI 1.1-4.9; P=0.03).
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