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Is Admission Hyperglycemia Associated with Reduced Ejection Fraction in ST elevation Myocardial Infarction without Diabetes?

Author : S.P.I Nasruddin , A.A Nursidiq, N. Purwaningtyas. A. Sukmawarti, G. S. Putri
Upload Date : 19-04-2018

Background: Increased plasma glucose is a common feature during early after ST elevation myocardial infraction (STEMI). In the literature, the proportion of patients who had hyperglycemia on admission ranged from 3% to 71% in patients without diabetes. Previous studies have demonstrated that acute hyperglycemia is associated with impaired left ventricular (LV) function. However, there is debate whether acute hyperglycemia is causally related to large infarct and impaired LV function after STEMI. The aim of this study is to identify association between admission hyperglycemia and ejection fraction (EF) in STEMI without diabetes.

Methods: Design this study is cross-sectional with total of 89 subject with STEMI without diabetes from January 2017 to October 2017 in Dr. Moewardi hospital. Random blood glucose (RBG) was obtained at admission and transthoracic echocardiography to measure EF with simpson method were performed to all subject. Admission hyperglycemia is defined by RBG > 140 mg/dL. There divided into two group according to result of EF measurement, EF ≥ 40 % and EF < 40 %. Statistical analysis was performed with chi-square test for categorical data, p value < 0.05 considered significantly. Bivariate and multivariate analysis were performed to assess whether high RBG was associated with EF < 40 %.

Results: There were 33 subject (EF<40%) and 56 subject (EF≥40%). Admission hyperglycemia has a significant association with EF < 40 % on bivariate analysis (p=<0.001) and multivariate analysis (p=<0.001). Admission hyperglycemia had risk to reduced EF (bivariate analysis: odds ratio (OR) 7.16, 95%CI = 2.72-18.86; multivariate analysis OR 9.77, 95%CI = 3.13-30.53). Beside admission hyperglycemia, ages (>65 years old) and no fibrinolytic therapy were associated with EF < 40 % (p=<0.05). 

Conclusions: Admission hyperglycemia had significant association with reduced ejection fraction in STEMI without diabetes.

KEYWORDS : Hyperglycemia, STEMI.

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