Key result
Acute hyperglycemia correlates with ventricular systolic dysfunction, while time-average glucose predicts 6-month rehospitalization.
Why the study?
Do indicators of acute, persistent, or chronic hyperglycaemia correlate with myocardial injury, ventricular dysfunction, and clinical outcomes in patients with acute coronary syndrome?
Cohort (n=226)
Do indicators of acute, persistent, or chronic hyperglycaemia correlate with myocardial injury, ventricular dysfunction, and clinical outcomes in patients with acute coronary syndrome?
Acute hyperglycaemia at admission and fasting glucose serve as surrogate markers for ventricular systolic dysfunction and myocardial necrosis in ACS, while time average glucose predicts 6-month re-hospitalization.
Answers are grounded in this paper and cite their sources.
Acute hyperglycaemia markers associate with injury and rehospitalization in ACS; hypothesis-generating and should not change practice.
BACKGROUND: The clinical significance of moment measurements (admission and fasting glycaemia), persistent (hyperglycaemic index, HGI; time average glucose, TAG; mean glucose; maximum glucose) or chronic hyperglycaemia (HbA1c), estimated average glucose, eAG) is still elusive in clinical practice. AIM: To identify the clinical significance of hyperglycaemia in ACS. METHODS: The study included 226 consecutive patients with ACS. Indicators for hyperglycaemia were defined, calculated and a correlation analysis with standard parameters-EF, maximum CPK, maximum CPK-MB and troponin was performed. Patients were followed up for 12 months. RESULTS: Indicators for persistent and chronic hyperglycaemia correlated neither to ejection fraction, nor to the enzymes for myocardial necrosis (P > 0.05). In contrast, acute hyperglycaemia correlated negatively with ventricular systolic dysfunction (P = 0.001/0.007) and positively with maximum CPK, MB and troponin (P = 0.0001/0.008). TAG was an independent predictor for 6-month re-hospitalization (P = 0.027) because of cardiac complications. CONCLUSION: Glycaemia at admission and fasting glucose could be used as metabolic surrogate markers for ventricular systolic dysfunction and TAG as an independent surrogate marker for six-month re-hospitalization. None of the indicators for hyperglycaemia could be used as independent prognostic factors for survival. Hyperglycaemia rather reflects an underlying impairment in glucose metabolism.
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Cherneva et al. (2011) conducted a cohort in Acute coronary syndrome (n=226). Hyperglycaemia was evaluated on Correlation with standard parameters (EF, maximum CPK, maximum CPK-MB and troponin) and 6-month re-hospitalization. Acute hyperglycaemia correlated with ventricular systolic dysfunction and cardiac enzymes, while time average glucose independently predicted 6-month re-hospitalization (P=0.027).
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