Effect of stress hyperglycemia on admission and glycosylated hemoglobin on left ventricular function and inflammatory factors in patients with diabetes mellitus combined with myocardial infarction undergoing PCI

• Published in: International journal of diabetes in developing countries 2023-06, Vol.43 (3), p.412-418
• Main Authors: Zhang, Yanyan, Wu, Jun, Huang, Ting, Yang, Qinghua, Zhou, Qing, Ding, Xi
• Format: Article
• Language: English
• Subjects: Diabetes; Diabetes mellitus; Family Medicine; General Practice; Health Administration; Heart; Heart attacks; Hemoglobin; Hyperglycemia; Inflammation; Interleukin 6; Medicine; Medicine & Public Health; Myocardial infarction; Original Article; Prognosis; Risk factors; Tumor necrosis factor-α; Ventricle
• ISSN: 0973-3930; 1998-3832
• DOI: 10.1007/s13410-022-01090-3

Purpose In this study, we analyzed the effect of stress hyperglycemia on patients admitted with diabetes mellitus. The effects of glycated hemoglobin (HbA1c) on left ventricular function and inflammatory factors in these patients with diabetes mellitus and myocardial infarction undergoing percutaneous coronary intervention (PCI) were also studied. Methods The clinical data of 160 patients with diabetes mellitus and myocardial infarction treated with PCI over the period of December 2018 to June 2020 were retrospectively analyzed. The patients were divided into groups A (38 cases), B (40 cases), C (43 cases), and D (39 cases) according to their blood glucose (AG) and HbA1c levels upon admission. Results The levels of FGB, 2hPG, and HbA1c in group B after PCI were significantly higher than those in groups A, C, and D ( p < 0.05). After PCI, group B showed significantly higher levels of LVESD and LVEDD and significantly lower levels of LVEF than other groups ( p < 0.05). The levels of TNF-α, IL-6, and CRP in group B after PCI were significantly higher than those in other groups ( p < 0.05). The incidence of endpoint events was higher in group B (35.00%) than in the other three groups ( p < 0.05). Multiple logistic regression analysis indicated that high AG and HbA1c levels were the main risk factors for adverse prognosis ( p < 0.05). AG and HbA1c were positively correlated with LVESD, LVEDD, TNF-α, IL-6, and CRP levels, and negatively correlated with LVEF levels ( p < 0.05). Conclusions In summary, in patients with diabetes mellitus combined with myocardial infarction and undergoing PCI on admission, stress hyperglycemia and high HbA1c levels were associated with higher FGB and 2hPG levels, which exacerbate ventricular functional impairment and inflammatory response, increase the risk of endpoint events, and can be predictors of patient prognosis.