title: Association between hyperglycemia, heart failure and mortality in stroke patients.
abstract: BACKGROUND
  Acute hyperglycemia predicts increased mortality after stroke. The aim of our study was to determine if acute stroke patients with hyperglycemia suffer from increased rate of in-hospital adverse events which could influence survival such as pneumonia, heart failure and myocardial infarction.
  
  
  METHODS
  In a retrospective study with prospective follow-up, 689 patients with first-ever ischaemic stroke and high frequency of cardiovascular diseases were eligible. Follow-up period was 1-7 years (14 308 person-months).
  
  
  RESULTS
  The frequency of in-hospital heart failure and nosocomial pneumonia was the highest in patients without pre-hospital diagnosis of diabetes mellitus and with fasting glucose >or=7 mmol/l (50% and 20.2%, respectively) and the lowest in patients without pre-hospital diagnosis of diabetes and fasting glucose <or=6.1 mmol/l (12.3% and 8.1%). On multivariate analysis fasting glucose was significantly associated with risk of in-hospital heart failure (OR: 1.12, 95% CI: 1.01-1.23), but not with pneumonia. Glucose level was an independent predictor of mortality only when statistical model did not include heart failure as a variable.
  
  
  CONCLUSIONS
  In stroke patients with hyperglycemia increased rate of heart failure could be responsible for higher mortality.
authors.affiliation: Department of Neurology, Collegium Medicum, Jagiellonian University, Krakow, Poland. dziedzic@cm-uj.krakow.pl
authors.forename: T
authors.initials: T
authors.lastname: Dziedzic
authors.forename: A
authors.initials: A
authors.lastname: Slowik
authors.forename: J
authors.initials: J
authors.lastname: Pera
authors.forename: A
authors.initials: A
authors.lastname: Szczudlik
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000453:epidemiology; D020521:Stroke / Q000150:complications* / Q000401:mortality*