medigraphic.com
ISSN 1561-2937 (Print)

2019, Number S1

<< Back Next >>

Rev Cubana Cardiol Cir Cardiovasc 2019; 25 (S1)

Leukocytosis and hyperglycemia as prognostic factors in patients with acute myocardial infarction

Martínez GG, Chipi RY, Carrero VAM, Cisneros SLG, González MY, Reynosa PN

Language: Spanish
References: 25
Page:
PDF size: 1014.02 Kb.


ABSTRACT

Introduction: despite new techniques for reperfusion of the vessel in acute myocardial infarction, complications and mortality in these patients is high. Hyperglycemia and leukocytosis have been described as risk factors and worse prognosis.
Objective: to demonstrate the importance of hyperglycemia and leukocytosis as risk factors for intrahospital complications of myocardial infarction with ST segment elevation.
Method: an analytical, longitudinal and prospective cohort study from 2013 to 2019 that included 345 consecutive patients admitted to the Intensive Coronary Care Unit of the "Dr. Carlos J. Fin-lay" Central Military Hospital and the "Enrique General Teaching Hospital" Cabrera ”with the diagnosis of acute myocardial infarction with ST segment elevation.
Results: The mean age was 63.5 ± 11.6 years, the male sex prevailed (64.9%). The main risk factors: high blood pressure and smoking. Of the total number of patients, 128 suffered in-hospital complications. The Killip-Kimball ≥ II functional class, the non-performance of percutaneous coronary intervention and the stay were independent prognostic factors of adverse events during admission. Fasting hyperglycemia was shown as an independent predictor of complications (p = 0.0459); not so leukocytosis (p = 0.0746). Hyperglycemia, measured through fasting glycemia, is an independent predictor of in-hospital complications of acute myocardial infarction with ST-segment elevation.


REFERENCES

  1. Mozaffarian D, Benjamin EJ, Go AS. Heart diseaseand stroke statistics−2016 update: a report from the American Heart Association. Circulation. 2016; 133:e38–360.

  2. Ministerio de Salud Pública Cuba. AnuarioEstadístico de Salud 2018. La Habana, 2019. Disponible en: http://www.sld.cu/sitios/dne/.

  3. TownsendN, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016; 37(42):3232–3245.

  4. Bajaj A, Sethi A, Rathor P, Suppogu N, Sethi A.Acute complications of myocardial infarction in the current era: diagnosis and management. J Investig Med. 2015; 63:844–55.

  5. Schiele F, Gale CP, Bonnefoy E, Capuano F,Claeys MJ, Danchin N, et al. Quality indicators for acute myocardial infarction: a position paper of the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care. 2017; 6:34–59.

  6. Bebb O, Hall M, Fox KAA, Dondo TB, Timmis A,Bueno H, et al. Performance of hospitals according to the ESC ACCA quality indicators and 30- day mortality for acute myocardial infarction: national cohort study using the United Kingdom Myocardial Ischaemia National Audit Project (MINAP) register. Eur Heart J. 2017; 38:974–82.

  7. Ibáñez B, James S, Agewall S, Antunes MJ,Bucciarelli-Ducci C, Bueno H, et al. Guía ESC 2017 sobre el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev Esp Cardiol. 2017; 70(12):1082.e1-e61.

  8. Fonarow GC, Heidenreich PA, Albert NM, BarnesGD, Chan PS, Curtis LH, et al. 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction. A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes. 2017; 10:e000032.

  9. Antman EM, Cohen M, Bernink PJ, McCabe CH,Horacek T, Papuchis G, et al. The TIMI risk score for ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000; 284: 835-42.

  10. Moore KJ, Sheedy FJ, Fisher EA. Macrophages inatherosclerosis: A dynamic balance. Nat Rev Immunol. 2013; 13:709.

  11. Swirski FK, Nahrendorf M, Libby P. The ins andouts of inflammatory cells in atheromata. Cell Metab. 2012; 15:135.

  12. Senthinathan A, Kelly V, Dzingina M, Jones D,Baker M, Longson D, Guideline Development Group. Hyperglycemia in acute coronary syndromes: summary of NICE guidance. BMJ. 2011; 343:d6646.

  13. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR,Bax JJ, Morrow DA, et al. Consenso ESC 2018 sobre la cuarta definición universal del infarto de miocardio. Rev Esp Cardiol. 2019; 72(1): 72.e1-e27.

  14. Mi Sh, Su G, Yang H, Zhou Y, Tian L, Zhang T, etal. Comparison of in-hospital glycemic variability and admission blood glucose in predicting short-term outcomes in non-diabetes patients with ST elevation myocardial infarction underwent percutaneous coronary intervention. Diabetol Metab Syndr. 2017; 9:20.

  15. American Diabetes Association. Diagnosis andclassification of Diabetes Mellitus. Diabetes Care. 2011; 34 (Suppl 19):62-89.

  16. Zhao Sh, Murugiah K, Li N, Li X, Xu Z-H, Li J, et al.Admission Glucose and In‑hospital Mortality after Acute Myocardial Infarction in Patients with or without Diabetes: A Cross-sectional Study. Chin Med J. 2017 Apr 5; 130 (7):767-73.

  17. Galindo-García G, Eugenia Galván-Plata ME,Nellen-Hummel H, Almeida-Gutiérrez E. Asociación entre hiperglucemia de estrés y complicaciones intrahospitalarias. Rev Med Inst Mex Seguro Soc. 2015; 53(1):6-12.

  18. Santos MM, Barreiro AG, García RQG, BarreiroAEN. Factores de riesgo de mortalidad hospitalaria post infarto agudo de miocardio. Rev Cub Cardiol Cirug Cardiovasc. 2017; 23(3):27-44.

  19. Karetnikova V, Gruzdeva O, Uchasova E, OsokinaA, Barbarash O. Glucose levels as a prognostic marker in patients with ST-segment elevation myocardial infarction: a case–control study. BMC Endocr Disorders. 2016; (16):31.

  20. Kalińczuk Ł, Zieliński K, Pręgowski J, Przyłuski J,Karcz M, Bekta P, et al. Higher admission glycaemia independently of diagnosed or unrecognized diabetes mellitus is a risk factor for failed myocardial tissue reperfusion and higher mortality after primary angioplasty. Kardiol Pol. 2018; 76(3): 594–601.

  21. Gomez-Arbelaez D, Sánchez-Vallejo G, Perez M,Gerardo RG, Freddy JA, Peñaherrera E, et al. Hiperglucemia se asocia a mayor número de desenlaces adversos en individuos latinoamericanos con infarto agudo de miocardio. Clin Investig Arterioscler. 2015. http://dx.doi.org/10.1016/j.arteri.2015.09.003.

  22. Issa M, Alqahtani F, Berzingi Ch, Al‑Hajji M, BusuY, Alkhouli M. Impact of acute diabetesdecompensation on outcomes of diabetic patientsadmitted with ST-elevation myocardial infarction.Diabetol Metab Syndr. 2018; 10:57.https://doi.org/10.1186/s13098-018-0357-y

  23. Lee TF, Burt MG, Heilbronn LK, Mangoni AA,Wong VW, McLean M, et al. Relative hyperglycemia is associated with complications following an acute myocardial infarction: a post-hoc analysis of HI-5 data. Cardiovasc Diabetol. 2017; 16:157. https://doi.org/10.1186/s12933-017-0642-3

  24. Canto J, Rogers W, Rogers W. DiferenciasClínicas del Infarto Agudo de Miocardio en Relación con la Edad y el Sexo. JAMA. 2012 Feb; 307(8):813-22.

  25. Comparán-Núñez A, Palacios JM, Jerjes-SánchezCD.Leucocitosis y su asociación con eventoscardiovasculares adversos en sujetos con infarto y elevación de ST sometidos a intervención coronaria percutánea. Arch Cardiol Mex. Jul-Sep 2005; 75 Suppl 3:S61-8.




2020     |     www.medigraphic.com