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@article{1397228,
author = {Kataja, A. and Tarvasmaki, T. and Lassus, J. and Cardoso, J. and Mebazaa, A. and Kober, L. and Sionis, A. and Špinar, Jindřich and Carubelli, V. and Banaszewski, M. and Marino, R. and Parissis, J. and Nieminen, M.S. and Harjola, V.P.},
article_location = {Clare (Ireland)},
article_number = {JAN 1 2017},
doi = {http://dx.doi.org/10.1016/j.ijcard.2016.10.033},
keywords = {Cardiogenic shock; Acute coronary syndrome; Blood glucose; Hyperglycemia; Hypoglycemia; Prognosis},
language = {eng},
issn = {0167-5273},
journal = {International Journal of Cardiology},
title = {The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock - Results from the CardShock Study},
volume = {226},
year = {2017}
}
TY - JOUR
ID - 1397228
AU - Kataja, A. - Tarvasmaki, T. - Lassus, J. - Cardoso, J. - Mebazaa, A. - Kober, L. - Sionis, A. - Špinar, Jindřich - Carubelli, V. - Banaszewski, M. - Marino, R. - Parissis, J. - Nieminen, M.S. - Harjola, V.P.
PY - 2017
TI - The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock - Results from the CardShock Study
JF - International Journal of Cardiology
VL - 226
IS - JAN 1 2017
SP - 48-52
EP - 48-52
PB - Elsevier Ireland Ltd.
SN - 01675273
KW - Cardiogenic shock
KW - Acute coronary syndrome
KW - Blood glucose
KW - Hyperglycemia
KW - Hypoglycemia
KW - Prognosis
N2 - Background: Critically ill patients often present with hyperglycemia, regardless of previous history of diabetes mellitus (DM). Hyperglycemia has been associated with adverse outcome in acute myocardial infarction and acute heart failure. We investigated the association of admission blood glucose level with the clinical picture and short-term mortality in cardiogenic shock (CS). Methods: Consecutively enrolled CS patients were divided into five categories according to plasma glucose level at the time of enrolment: hypoglycemia (glucose <4.0 mmol/L), normoglycemia (4.0-7.9 mmol/L), mild (8.0-11.9 mmol/L), moderate (12.0-15.9 mmol/L), and severe (>= 16.0 mmol/L) hyperglycemia. Clinical presentation, biochemistry, and short-term mortality were compared between the groups. Results: Plasma glucose level of 211 CS patients was recorded. Glucose levels were distributed equally between normoglycemia (26% of patients), mild (27%), moderate (19%) and severe (25%) hyperglycemia, while hypoglycemia (2%) was rare. Severe hyperglycemia was associated with higher blood leukocyte count (17.3 (5.8) E9/L), higher lactate level (4.4 (3.3-8.4) mmol/L) and lower arterial pH (7.23 (0.14)) compared with normoglycemia or mild to moderate hyperglycemia (p < 0.001 for all). In-hospital mortality was highest among hypoglycemic (60%) and severely hyperglycemic (56%) patients, compared with 22% in normoglycemic group (p < 0.01). Severe hyperglycemia was an independent predictor of in-hospital mortality (OR 3.7, 95% CI 1.19-11.7, p = 0.02), when adjusted for age, gender, LVEF, lactate, and DM. Conclusions: Admission blood glucose level has prognostic significance in CS. Mortality is highest among patients with severe hyperglycemia or hypoglycemia. Severe hyperglycemia is independently associated with high in-hospital mortality in CS. It is also associated with biomarkers of systemic hypoperfusion and stress response. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
ER -
KATAJA, A., T. TARVASMAKI, J. LASSUS, J. CARDOSO, A. MEBAZAA, L. KOBER, A. SIONIS, Jindřich ŠPINAR, V. CARUBELLI, M. BANASZEWSKI, R. MARINO, J. PARISSIS, M.S. NIEMINEN and V.P. HARJOLA. The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock - Results from the CardShock Study. \textit{International Journal of Cardiology}. Clare (Ireland): Elsevier Ireland Ltd., 2017, vol.~226, JAN 1 2017, p.~48-52. ISSN~0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2016.10.033.
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