Predictors of stress hyperglycemia in patients with acute phase of Q-wave myocardial infarction complicated by acute heart failure without diabetes history

N I Kapshytar,V D Syvolap

doi:10.14739/2310-1210.2018.3.130809

Abstract

The aim was to identify the predictors of stress hyperglycemia in patients with acute phase of Q-wave myocardial infarction complicated by acute heart failure without diabetes history. Materials and methods. 55 patients in acute phase of Q-wave myocardial infarction complicated by acute heart failure were examined. 38 (67 %) of them were male. The average age was 63 ± 10.6 years. Stress hyperglycemia was revealed in 32 persons on admission. The average level of glucose in patients with hyperglycemia was 9.25 ± 0.35 mmol/l, with normoglycemia – 6.05 ± 0.23 mmol/l. When constructing the multivariate linear regression model we used the data from anamnesis and body mass index calculation. Diabetes mellitus in past history and diabetes mellitus first-diagnosed on further patient’s examination were the exclusion criteria. Results. Three reliable risk factors in the construction of multivariate linear regression model were identified: male, body mass index and history of rhythm disorders. With increasing body mass index by 10g/m 2 the levels of glycemia increased by 2.1 mmol/l, glucose level in men was higher than in women by 1.4 mmol/l and the past history of rhythm disorders increased the level of glucose by 3.01 mmol/l. The coefficient of determination (R-squared) was 0.95, which confirmed the high quality of the model. Body mass index was determined to have the greatest impact, using coefficient of elasticity (e = 0.727). The increase of 1% in body mass index led to increase in glucose level by an average of 0.73 %. The relative risk of stress hyperglycemia in patients with a past history of rhythm disorders was 2.94 (95 % CI 1,77–4,88), P ≤ 0.05. Conclusions. In patients with the acute phase of Q-wave myocardial infarction, complicated by acute heart failure, the predictors of stress hyperglycemia development were the body mass index, male and past history of rhythm disorders. In patients with history of rhythm disorders the relative risk of stress hyperglycemia was 2.94 times higher than in persons without history of rhythm disorders.

Highlights

Materials and methods. 55 patients in acute phase of Q-wave myocardial infarction complicated by acute heart failure were examined. 38 (67 %) of them were male
Stress hyperglycemia was revealed in 32 persons on admission
With increasing body mass index by 10 g/m2 the levels of glycemia increased by 2.1 mmol/l, glucose level in men was higher than in women by 1.4 mmol/l and the past history of rhythm disorders increased the level of glucose by 3.01 mmol/l

Summary

Introduction

При построении модели множественной линейной регрессии установили 3 достоверные фактора риска: мужской пол, индекс массы тела и нарушение ритма в анамнезе. При увеличении ИМТ на 10 г/м2 уровень гликемии увеличится в среднем на 2,1 ммоль/л; у мужчин уровень гликемии в среднем на 1,4 ммоль/л выше, чем у женщин, а наличие нарушений ритма в анамнезе увеличивает уровень гликемии в среднем на 3,01 ммоль/л. Относительный риск развития стрессовой гипергликемии у пациентов с нарушением ритма в анамнезе составил 2,94 (95 % ДИ 1,77–4,88), р ≤ 0,05. У больных в остром периоде Q-инфаркта миокарда, осложненного острой сердечной недостаточностью, предикторами развития стрессовой гипергликемии являются ИМТ, мужской пол и наличие нарушений ритма в анамнезе. У пациентов с нарушением ритма относительный риск развития стрессовой гипергликемии в 2,94 раза выше, чем у лиц без нарушений ритма. Мета роботи – виявити предиктори стресової гіперглікемії у хворих у гострому періоді Q-інфаркту міокарда, що ускладнений гострою серцевою недостатністю, без цукрового діабету в анамнезі

Methods

Results

Conclusion