title: Stress-induced hyperglycemia after hip fracture and the increased risk of acute myocardial infarction in nondiabetic patients.
abstract: OBJECTIVE
  To investigate the risk of acute myocardial infarction (AMI) following stress hyperglycemia after hip fracture.
  
  
  METHODS
  From February 2007 to February 2012, we carried out a prospective observational analysis of 1,257 consecutive patients with no history of diabetes who suffered hip fractures. Fasting blood glucose (FBG) and glycosylated hemoglobin tests as well as electrocardiography, ultrasonic cardiography, and chest X-ray examinations were performed after admission. All selected hip fracture patients were divided into stress hyperglycemia and non-hyperglycemia groups according to their FBG, and the incidence of AMI was monitored.
  
  
  RESULTS
  Among the patients enrolled, the frequency of stress hyperglycemia was 47.89% (602/1,257) and that of AMI was 9.31% (117/1,257), and the occurrence of AMI in the stress hyperglycemia group was higher than in the non-hyperglycemia group (12.46 vs. 6.41%, P<0.05). In the stress hyperglycemia patients, FBG reached maximum levels at 2-3 days after hip fractures and then decreased gradually. The AMI incidence (62.67% [47/75]) of the stress hyperglycemia group was highest in the initial 3 days after hip fracture, significantly coinciding with the FBG peak time (P<0.05). In all patients with AMI, non-ST-segment elevation myocardial infarction occurred more often than ST-segment elevation myocardial infarction (62.39% [73/117] vs. 37.61% [44/117]).
  
  
  CONCLUSIONS
  Stress-induced hyperglycemia after hip fracture increased the risk of AMI.
authors.affiliation: Corresponding authors: Xincun Yang, yxc6229@sina.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Xincun
authors.initials: X
authors.lastname: Yang
authors.forename: Kang
authors.initials: K
authors.lastname: Meng
authors.forename: Zechun
authors.initials: Z
authors.lastname: Zeng
authors.forename: Baotong
authors.initials: B
authors.lastname: Ma
authors.forename: Xingpeng
authors.initials: X
authors.lastname: Liu
authors.forename: Baoqing
authors.initials: B
authors.lastname: Qi
authors.forename: Shuangshuang
authors.initials: S
authors.lastname: Cui
authors.forename: Peihong
authors.initials: P
authors.lastname: Cao
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000209:etiology* / Q000378:metabolism; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology* / Q000378:metabolism; D011446:Prospective Studies; D013312:Stress, Physiological / Q000502:physiology*