Prognostic value of admission hyperglycaemia in black Africans with acute coronary syndromes: a cross-sectional study.

CARDIOVASCULAR JOURNAL OF AFRICA(2020)

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摘要
Aim: The aim of the study was determine the relationship between acute hyperglycaemia and in-hospital in black Africans with acute coronary syndromes (ACS). Methods: From January 2002 to December 2017. 1 168 patients aged >= 18 years old, including 332 patients with diabetes (28.4%). consecutively presented to the intensive care unit of the Abidjan Heart Institute for ACS. Baseline data and outcomes were compared in patients with and without hyperglycaemia at admission (> 140 mg/dl; 7.8 nunol/l). Predictors for death were determined by multivariate logistic regression. Results: The prevalence of admission hyperglycaemia was 40.6%. It was higher in patients with diabetes (55.3%). In multivariate logistic regression. acute hyperglycaemia (hazard ratio = 2.3:3; 1.44 3.77; p < 0,001), heart failure (HR = 2.22: 1.38-3.56; p = 0.001). reduced left ventricular ejection fraction (HR = 6.41; 3.72-11.03; p < 0.001, sustained ventricular tachycardia or ventricular fibrillation (HR = 3.43; 1.37--8.62: p = 0.008) and cardiogenic shock (HR = 8.82; 4.38 17.76; p < 0.001) were predictive factors associated with in-hospital death. In sub-group analysis according to the histoly of diabetes, hyperglycaemia at admission was a predictor for death only in patients without diabetes (HR = 3.12; 1.72-5.68; p < 0.001). Conclusion: In ACS patients and particularly those without a history of diabetes, admission acute hyperglycaemia was a potentially threatening condition. Appropriate management, follow up and screening for glucose metabolism disorders should be implemented in these patients.
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关键词
hyperglycaemia,diabetes,acute coronary syndrome,sub-Saharan Africa
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