Hari K. AGGARWAL, Tarana GUPTA, H. K. ACHARYA, Deepak JAIN, Ashwani KUMAR

Stress hyperglycemia as a prognostic indicator in non-diabetic myocardial infarction patients

Amaç. Bu çalışmanın amacı diabetes mellitusu olmayan akut myokard enfarktüsü (ME)hastalarında çeşitli komplikasyonların insidansı ve stress hipergilsemisinin prognostic önemininsaptanmasıdır. Yöntem. Bilinen diabetes mellitusu olmayan 50 akut myokard enfarktüslü hastaçalışmaya dahil edildi. Kan glukoz düzeylerine hastanın ilk başvurusunda daha sonra da düzenliolarak bakıldı. Hastanın kabülünde diyabetin ekarte edilmesi için glikolize hemoglobin bakıldı.Başlangıç glukoz düzeylerine dayanılarak hastalar 2 gruba ayrıldı. Grup Ayı kan glukoz düzeyleri

Non-diabetik miyokard enf arktüsü hastalarında p rognostic bir gösterge olarak stres hiperglisemisi

Aim. The present study aims to find out prognostic importance of stress hyperglycemia andincidence of various complications in patients of Acute myocardial infarction (MI) withoutdiabetes mellitus. Method. We studied 50 patients admitted with acute MI without previousdiabetes mellitus. Blood glucose level were estimated at time of admission and regularlythereafter. Glycosylated hemoglobin was estimated at the time of admission to rule out diabetes.Based on the blood glucose level at time of admission, patients in the study were divided into twogroups i.e. Group A (patients with blood glucose level

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1. Stranders I, Diamant M, van Gelder RE, Spruijt HJ, Twisk JW, Heine RJ, Visser FC. Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch Intern Med 2004; 164; 982-8.
2. Oswald GA, Smith CC, Betteridge DJ, Yudkin JS. Determinants and importance of stress hyperglycemia in non diabetic patients with myocardial infarction. Br Med J (Clin Res Ed) 1986; 293: 917-22.
3. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systemic overview. Lancet 2000; 355: 773-8.
4. Clarke RS, Johnston H, Shreidan B. The influence of anaesthesia and surgery on plasma cortisol, insulin and free fatty acids. Br J Anaesth 1970; 42: 295-9.
5. Oliver MF, Opie LH. Effects of glucose and fatty acids on myocardial ischaemia and arrhythmias. Lancet 1994; 343: 155-8.
6. Soler NG, Frank S.Value of glycosylated hemoglobin measurements after acute myocardial infarction. JAMA 1981; 246: 1690-3.
7. Celik T, Iyisoy A, Turhan H, Isik E. Transient hyperglycemia in patients with acute myocardial infarction: time to define optimal glucose levels. Int J Cardiol 2008; 130: 472-3.
8. Otto NM, Schindler R, Lun A, Boenisch O, Frei U, Oppert M. Hyperosmotic stress enhances cytokine production and decreases phagocytosis in vivo. Crit Care 2008; 12: R107.
9. Foo K, Cooper J, Deaner A, Knight C, Suliman A, Ranjadayalan K, Timmis AD. A single serum glucose measurement predicts adverse outcomes across the whole range of acute coronary syndromes. Heart 2003; 89: 512-6.
10. Doenst T, Wijeysundera D, Karkouti K, Zechner C, Maganti M, Rao V, Borger MA. Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2005; 130: 1144.
11. Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendíc S, Rydén L, Malmberg K. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 2002; 359: 2140-4.
12. Timmer JR, van der Horst IC, Ottervanger JP, Henriques JP, Hoorntje JC, de Boer MJ, Suryapranata H, Zijlstra F; Zwolle Myocardial Infarction Study Group. Prognostic value of admission glucose in non-diabetic patients with myocardial infarction. Am Heart Journal 2004; 148: 399-404.
13. Oswald GA, Corcoran S, Yudkin JS. Prevalence and risks of hyperglycaemia and undiagnosed diabetes in patients with acute myocardial infarction. Lancet 1984; 1: 1264-7.