FREQUENCY OF ADVERSE OUTCOMES OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH STRESS HYPERGLYCEMIA

Abstract

Objective: To determine the frequency of in-hospital adverse outcomes of acute
myocardial infarction in patients with stress hyperglycemia.
Methodology: This was a descriptive cross sectional study conducted from
August 2010 to January 2011 in Cardiology department, Lady Reading Hospital,
Peshawar. Patients of age 25-70 years, of either gender, non-diabetic with acute
myocardial infarction with stress hyperglycemia were included. Random blood
sugar >144 mg/dl was taken as stress hyperglycemia for patients at
presentation of acute myocardial infarction. Patients were monitored for
electrical complications such as atrial fibrillation, ventricular tachycardia,
ventricular fibrillation and complete heart block and mechanical complications
such as cardiac pulmonary edema and cardiogenic shock during hospital stay.
The statistical analysis was performed using the statistical package for social
sciences (SPSS Ver. 15.0).
Results: A total of 341 patients having acute myocardial infarction with stress
hyperglycemia were studied. The mean age was 56.35 ± 9.748 (95% CI 57.39 –
55.31). Male were 58.1% (n=198). The frequency of various major in-hospital
electrical adverse outcomes of acute myocardial infarction with stress
hyperglycemia were atrial fibrillation (AF) 15.8%, ventricular tachycardia (VT)
11.7%, ventricular fibrillation (VF) 10.9% and complete heart block (CHB) 6.7%,
while mechanical adverse outcomes were cardiac pulmonary edema (CPE) 7.9%
and cardiogenic shock (CS) 11.7%.
Conclusion: Stress hyperglycemia has adverse impact on outcomes of patients
presenting with acute myocardial infarction. Among electrical and mechanical
complications of acute myocardial infarction in patients with stress
hyperglycemia, the two most frequent in-hospital adverse outcomes were atrial
fibrillation and cardiogenic shock, respectively.