In–Hospital Morbidity and Mortality of  Nondiabetic Patients of Acute Myocardial  Infarction In Relation to their Blood  Glucose Status

Dr.Haridas B .Prasad; Dr.Prashant Mahajan; Dr.Dilip B.Kadam

Volume : II, Issue : VIII, August - 2013

In–Hospital Morbidity and Mortality of Nondiabetic Patients of Acute Myocardial Infarction In Relation to their Blood Glucose Status

Dr. Haridas B . Prasad, Dr. Prashant Mahajan, Dr. Dilip B. Kadam

Abstract :

INTRODUCTION-Transient hyperglycemias during AMI is related to stress hence labeled as stress Hyperglycemia . It is related to higher mortality and cardiac complications in diabetic as well as in non diabetic patients with higher frequency of cardiogenic shock. AIMS This study compared the complications of AMI in non-diabetic patients with stress hyperglycemia and those without it , assessed the prognostic significance of stress hyperglycemia and mortality .MATERIALS AND METHODS: 90 patients were incuded.Detailed clinical examination and laboratory work up including ECG ,Echo and HbA1c was done EXCLUSION CRITERIA:Those with diabetes. non-Q wave MI or unstable angina or previous history of MI and on (5% dextrose or DNS) and LBBB were excluded. RESULTS Non-diabetic patients of AMI with stress hyperglycemia developed significantly higher complications, as compared to controls i.e. 66.6% in cases and 23.31% in control.The patients who died had significant higher mean admission blood glucose (203.44 +67.57) (mg %) than in survivors (153.09 + 63.94)(mg %).Causes of infarct related death were cardiogenic shock and ventricular arrhythmias. Incidence of heart failure was significantly higher in non-diabetic patients with stress hyperglycemia (59.94%) as compared to the control patients (10%) Mortality rate increased with increasing blood glucose level on admission and was related to higher frequency of heart failure and cardiogenic shock. CONCLUSION Stress hyperglycemia plays an important role in prognosis and outcome in non-diabetic patients admitted with AMI.