J 2017

The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock - Results from the CardShock Study

KATAJA, A., T. TARVASMAKI, J. LASSUS, J. CARDOSO, A. MEBAZAA et. al.

Základní údaje

Originální název

The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock - Results from the CardShock Study

Autoři

KATAJA, A. (246 Finsko), T. TARVASMAKI (246 Finsko), J. LASSUS (246 Finsko), J. CARDOSO (620 Portugalsko), A. MEBAZAA (250 Francie), L. KOBER (208 Dánsko), A. SIONIS (724 Španělsko), Jindřich ŠPINAR (203 Česká republika, garant, domácí), V. CARUBELLI (380 Itálie), M. BANASZEWSKI (616 Polsko), R. MARINO (380 Itálie), J. PARISSIS (300 Řecko), M.S. NIEMINEN (246 Finsko) a V.P. HARJOLA (246 Finsko)

Vydání

International Journal of Cardiology, Clare (Ireland), Elsevier Ireland Ltd. 2017, 0167-5273

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Irsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.034

Kód RIV

RIV/00216224:14110/17:00098546

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

000390473400008

Klíčová slova anglicky

Cardiogenic shock; Acute coronary syndrome; Blood glucose; Hyperglycemia; Hypoglycemia; Prognosis

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 21. 3. 2018 16:15, Soňa Böhmová

Anotace

V originále

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.