Stress hyperglycemia in acute ST-segment elevation myocardial infarction is a marker of left ventricular remodeling.

Abstract

Introduction: Stress hyperglycemia (SH) in STEMI is associated with high risk of in-hospital mortality. It is still controversial if SH is marker of high post-hospital risk.

Objectives: The aim was to analyze in-hospital and one-year risk associated with SH in STEMI and to study if SH is marker of LV remodeling.

Methods: We enrolled 275 patients who were admitted with first STEMI and reperfused. Patients were divided according to admission glycemia in three groups: (1) with diabetes mellitus (DM); (2) with SH, without DM and; (3) without both DM and SH. SH was defined as admission blood glucose level ≥ 8 mmol/l.

Results: In-hospital mortality was higher in patients with known DM (5%) and highest in patients with SH without previous DM (9.3%), and only 1.6% in the third group, P < 0.05. In patients without known DM, SH was associated with 6.378-fold higher in-hospital mortality. Total mortality was double in group with SH without DM compared to the third group (13.9% versus 6.3%). EDV changed in patients with SH without DM from 126 ± 37 to 145 ± 30 ml after one year, P < 0.05.

Conclusion: SH is associated with high in-hospital mortality risk and it could be marker of LV remodeling (significant increase of EDV during one year).