Association between hyperglycemia, heart failure and mortality in stroke patients

Abstract

Acute hyperglycemia predicts increased mortality after stroke. The aim of our study was to determine if acute stroke patients with hyperglycemia suffer from increased rate of in-hospital adverse events which could influence survival such as pneumonia, heart failure and myocardial infarction. In a retrospective study with prospective follow-up, 689 patients with first-ever ischaemic stroke and high frequency of cardiovascular diseases were eligible. Follow-up period was 1-7 years (14 308 person-months). The frequency of in-hospital heart failure and nosocomial pneumonia was the highest in patients without pre-hospital diagnosis of diabetes mellitus and with fasting glucose >or=7 mmol/l (50% and 20.2%, respectively) and the lowest in patients without pre-hospital diagnosis of diabetes and fasting glucose <or=6.1 mmol/l (12.3% and 8.1%). On multivariate analysis fasting glucose was significantly associated with risk of in-hospital heart failure (OR: 1.12, 95% CI: 1.01-1.23), but not with pneumonia. Glucose level was an independent predictor of mortality only when statistical model did not include heart failure as a variable. In stroke patients with hyperglycemia increased rate of heart failure could be responsible for higher mortality.