title: [The influence of stress hyperglycemia on the prognosis of patients with acute myocardial infarction and temporary electrical cardiac pacing].
abstract: BACKGROUND
  Elevated glucose levels on admission in many emergency conditions, including acute myocardial infarction (AMI), have been identified as a predictor of hospital mortality.
  
  
  OBJECTIVE
  Since there are no data in the literature related to stress hyperglycaemia (SH) in patients with both AIM and temporary electrical cardiac pacing, we aimed to investigate the influence of stress hyperglycaemia on the prognosis of patients with AMI and temporary electrical cardiac pacing.
  
  
  METHODS
  The prospective study included 79 patients with diagnosed AMI with ST-segment elevation (STEMI), admitted to the Coronary Care Unit of the Clinic for Cardiovascular Diseases, Clinical Centre Nis, from 2004 to 2007, who were indicated for temporary electrical cardiac pacing. The blood was sampled on admission for lab analysis, glucose levels were determined (as well as markers of myocardial necrosis troponin I, CK-MB). Echocardiographic study was performed and ejection fraction was evaluated by using area length method.
  
  
  RESULTS
  The ROC analysis indicated that the best glycaemic level on admission, which could be used as a predictor of mortality, was 10.00 mmol/l, and the area under the curve was 0.82. In the group without SH, hospital mortality was 3-fold lower 11/48 (22.91%) compared to the group with SH 19/31 (61.29%), p < 0.0001. Patients with SH were more likely to have higher troponin levels, Killip >1, lower ejection fraction and heart rate, as well as systolic blood pressure.
  
  
  CONCLUSIONS
  The best cut-off value for SH in patients with AMI (STEMI) and temporary electrical cardiac pacing is 10 mmol/l (determined by ROC curve) and may be used in risk stratification; patients with glucose levels <10 mmol/l on admission are at 3-fold lower risk compared to those with glucose levels >10 mml/l. Our results suggest that SH is a more reliable marker of poor outcome in AMI patients with temporary pace maker, without previously diagnosed DM.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Stojković
authors.forename: Goran
authors.initials: G
authors.lastname: Koracević
authors.forename: Zoran
authors.initials: Z
authors.lastname: Perisić
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Krstić
authors.forename: Milan
authors.initials: M
authors.lastname: Pavlović
authors.forename: Lazar
authors.initials: L
authors.lastname: Todorović
authors.forename: Jozef
authors.initials: J
authors.lastname: Glasnović
authors.forename: Ivana
authors.initials: I
authors.lastname: Burazor
authors.forename: Svetlana
authors.initials: S
authors.lastname: Apostolović
authors.forename: Gordana
authors.initials: G
authors.lastname: Nikolić
authors.forename: Tomislav
authors.initials: T
authors.lastname: Kostić
authors.forename: Natasa
authors.initials: N
authors.lastname: Branković
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D013312:Stress, Physiological