Admission hyperglycemia in patients with acute coronary syndrome complicated by cardiogenic shock

Abstract

Background: Many reports shoed that for patients with acute coronary syndrome (ACS) increased admission blood glucose (ABG) level is associated with adverse outcomes. Although scientific reports on this issue are still inconsistent, many recent studies confirm that hyperglycemia is also an unfavorable prognostic factor in patients with ACS complicated by cardio­genic shock (CS). The aim of this study is to determine if hyperglycemia on admission can be a predictor of in-hospital death in patients with ACS complicated by CS.

Methods: The study population consisted of 40 patients with ACS complicated by CS admit­ted to the Intensive Cardiac Therapy Clinic from January 2010 to May 2013 and treated with primary percutaneous coronary intervention. A control group was selected among patients with uncomplicated ACS.

Results: Patients with CS had significantly higher levels of ABG (15.4 ± 6.26 vs. 7.97 ± ± 2.28 mmol/L, p < 0.01) in comparison with the control group. There was no statistically significant correlation between the level of glucose on admission and in-hospital mortality. Average ABG in patients who survived and in those who died were respectively 15.42 ± 5.61 vs. 15.40 ± 6.87 mmol/L, p > 0.05. Comparison in groups depending on ABG level and cal­culations with use of receiver-operating characteristics curves showed no relationship between the level of ABG and patients’ deaths.

Conclusions: Hyperglycemia on admission is a clinical feature of patients with ACS who develop CS, however its prognostic value requires further studies.