A study of prognostic implications of admission hyperglycemia in non diabetic acute myocardial infarction patients

 

Sanjay Jagtap¹, Sham Toshniwal², Ankit Panjwani^3*

 

Abstract           Background: Elevated admission glucose levels in non diabetic patients with acute myocardial infarction are independently associated with large infarct sizes and a higher mortality rate when compared with patients with normal glucose levels. A strong correlation between glycaemia and shock or development of heart failure has also been reported. Aim and objectives: This study was conducted to assess the prognostic implications of admission hyperglycemia in non diabetic acute myocardial infarction patients. Methodology: The study was conducted on 150 non diabetic STEMI patients admitted in a tertiary hospital during 2018-2019. Patients with acute myocardial infarction proven by ECG, cardiac enzymes (Positive Troponin I or CPK-MB) and symptoms suggestive of acute myocardial infarction who have no previous history of diabetes with HbA1c <6.5 were included in the study. Results:Among patients with admission blood glucose ≤140 mg%, 6 patients (8.10%) developed cardiogenic shock, 4 patients (5.40%) developed arrhythmias, 3 patients (4.05%) developed AV block (≥2^nd degree) and 5 patients (6.75%) died during the hospital stay. Among patients with admission blood glucose >140 mg%,16 patients (21.05%) developed cardiogenic shock, 14 patients (18.42%) developed arrhythmias, 11 patients (14.47%) developed AV block and patients (14%) died during the hospital stay. The complications and mortality were significantly higher in patients with admission blood glucose >140 mg%. Conclusion: Hyperglycemia at admission in non diabetic patients of acute ST elevation myocardial infarction is strongly associated with higher in hospital complications like cardiogenic shock, arrhythmias and AV block and hospital stay mortality.