Stress hyperglycemia in acute miocardial infarction: is it associated with increased mortality? A concern of therapeutic behavior too

Authors

  • Guillermo Alzueta Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Juan Carlos Bauchi Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Endocrinology Specialist; Head of the Endocrinology and Diabetes Service Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Darío Rímoli Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Raúl Suárez Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Amílcar Sosa Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Carlos Santillán (h) Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Mirta Linares Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Ricardo Denaro Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Gracieta Zarza Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Adrián Decundo Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Olguita Vera Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Rosa Salazar Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Segundo Guzmán Rodríguez Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Abel Weinmeister Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Rodolfo Dettorre Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Karina Bastone Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Alfredo Caccavo Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Horacio Costa Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina
  • Claudio Daniel González Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos. Department of Pharmacology of the National University of Buenos Aires, Autonomous city of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v52i2.117

Keywords:

stress hyperglycemia, accessibility, acute myocardial infarction

Abstract

Introduction: stress hyperglycemia could increase mortality after acute myocardial infarction (AMI).

Objectives: we explored the association between hyperglycemia and mortality after AMI in a retrospective cohort study. We consider the treatment behavior of hyperglycemia too.

Materials and methods: the mortality rate at hospital discharge post AMI was obtained from a sample of 349 patients assisted in 11 hospitals, between May 2000 and April 2001.

Conclusions: mortality was positively associated with sex, age, Killip score, arrhythmia during hospitalization and hyperglycemia upon admission >Qs, and inversely with BP. Among patients with hyperglycemia, mortality was, compared to non-hyperglycemic patients, much higher in non-diabetics compared to diabetics. The effect of hyperglycemia was especially evident in patients admitted with Killip score 2. Approximately one third of hyperglycemic patients did not receive treatment for it. 90% of the treated patients received insulin and only 20% intravenously. The glycemic values ​​taken into account to start treatment were 50% higher than the value considered in our study as hyperglycemia. The therapeutic approach focused on intervening in the glycemia of known diabetics rather than on its value (82% vs 41.8%) even though the patients were hyperglycemic.

Author Biographies

Guillermo Alzueta, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Specialist in Endocrinology

Juan Carlos Bauchi, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Medical specialist; consultant in Endocrinology, senior in Medical Clinic and Diabetes; Master in Psycho-Immuno-Neuro-Endocrinology; Private practice

Endocrinology Specialist; Head of the Endocrinology and Diabetes Service, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Endocrinology Specialist; Head of the Endocrinology and Diabetes Service

Raúl Suárez, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Hierarchical Specialist in Medical Clinic; Former Head of the HIGA Medical Clinic Service Dr. O. E. Alende

Olguita Vera, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Endocrinologist

Segundo Guzmán Rodríguez, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos, Argentina

Consulting Specialist in Medical Clinic with Added Certification in Diabetes

Claudio Daniel González, Atlantic Chapter of the Argentine Diabetes Society (ATLANSAD): Balcarce, Punta Alta, Chacabuco, Junín, Mar del Plata, Bahía Blanca, Olavarría, Coronel Suárez, Puerto Madryn, Las Flores, Río Gallegos. Department of Pharmacology of the National University of Buenos Aires, Autonomous city of Buenos Aires, Argentina

Pharmacologist doctor; Advisor on the methodology of the clinical and epidemiological evidence qualification processes

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Published

2023-01-10

How to Cite

Alzueta, G., Bauchi, J. C., Dieuzeide, G., Rímoli, D., Suárez, R., Sosa, A., Santillán (h), C., Linares, M., Denaro, R., Zarza, G., Decundo, A., Vera, O., Salazar, R., Guzmán Rodríguez, S., Weinmeister, A., Dettorre, R., Bastone, K., Caccavo, A., Costa, H., & González, C. D. (2023). Stress hyperglycemia in acute miocardial infarction: is it associated with increased mortality? A concern of therapeutic behavior too. Journal of the Argentine Society of Diabetes, 52(2 (2018), 37–47. https://doi.org/10.47196/diab.v52i2.117

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