Prognostic Impact of Plasma Glucose on Patients With Cardiogenic Shock With or Without Diabetes Mellitus from the SMART RESCUE Trial

Autor: Seong Huan Choi, Gwang-Seok Yoon, Man-Jong Lee, Sang-Don Park, Young-Guk Ko, Chul-Min Ahn, Cheol Woong Yu, Woo Jung Chun, Woo Jin Jang, Hyun-Joong Kim, Bum Sung Kim, Jang-Whan Bae, Sang Yeub Lee, Sung Uk Kwon, Je Sang Kim, Wang Soo Lee, Jin-Ok Jeong, Seong-Hoon Lim, Sungsoo Cho, Jeong Hoon Yang, Hyeon-Cheol Gwon
Rok vydání: 2021
Předmět:
Zdroj: The American journal of cardiology. 175
ISSN: 1879-1913
Popis: Although the presence of hyperglycemia has been shown to affect the clinical outcome of patients with cardiogenic shock, the extent of hyperglycemia and its association with prognosis have not been fully addressed in a large population. A total of 1,177 consecutive patients with cardiogenic shock were enrolled from January 2014 to December 2018 at 12 hospitals in South Korea. The primary outcome was in-hospital mortality. Patients were divided into 4 groups according to their initial plasma glucose level in patients with diabetes mellitus (DM) (n = 752) and patients without DM (n=425); group 1 (≤8 mmol/L or 144 mg/100 ml), group 2 (8 to 12 mmol/L or 144 to 216 mg/100 ml), group 3 (12 to 16 mmol/L or 216 to 288 mg/100 ml), and group 4 (≥16 mmol/L or 288 mg/100 ml). The groups with higher admission plasma glucose were associated with lower systolic blood pressure and higher lactic acid levels in patients with and without DM. In-hospital mortality increased in groups with higher admission plasma glucose level in patients without DM (group 1:24.2%, group 2: 28.6%, group 3: 38.1%, group 4: 49.0%, p0.01), whereas in patients with DM, mortality and admission plasma glucose level showed no significant association (group 1: 45%, group 2: 35.4%, group 3: 33.3%, group 4: 43.1%, p = 0.26). Even after multivariate analysis, high plasma glucose was an independent predictor of in-hospital mortality in patients without DM. In patients with cardiogenic shock, plasma glucose obtained at admission was associated with in-hospital mortality in patients without DM.
Databáze: OpenAIRE