Hypoglycemia is associated with a higher risk of mortality and arrhythmias in ST-elevation myocardial infarction, irrespective of diabetes

Basel Humos, Ziyad Mahfoud, Soha Dargham, Jassim Al Suwaidi, Hani Jneid, Charbel Abi Khalil

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Aims: We aimed to assess the impact of hypoglycemia in ST-elevation myocardial infarction (STEMI). Background: Hypoglycemia increases the risk of mortality in patients with diabetes and high cardiovascular risk. Methods: We used the National Inpatient Sample (2005–2017) database to identify adult patients with STEMI as the primary diagnosis. The secondary diagnosis was hypoglycemia. We compared cardiovascular and socio-economic outcomes between STEMI patients with and without hypoglycemia and assessed temporal trends. Results: Hypoglycemia tends to complicate 0.17% of all cases hospitalized for STEMI. The mean age (±SD) of STEMI patients hospitalized with hypoglycemia decreased from 67 ± 15 in 2005 to 63 ± 12 in 2017 (p = 0.046). Mortality was stable with time, but the prevalence of ventricular tachycardia, ventricular fibrillation, acute renal failure, cardiogenic shock, total charges, and length of stay (LOS) increased with time (p < 0.05 for all). Compared to non-hypoglycemic patients, those who developed hypoglycemia were older and more likely to be black; only 6.7% had diabetes compared to 28.5% of STEMI patients (p = 0.001). Cardiovascular events were more likely to occur in hypoglycemia: mortality risk increased by almost 2.5-fold (adjusted OR = 2.625 [2.095–3.289]). There was a higher incidence of cardiogenic shock (adjusted OR = 1.718 [1.387–2.127]), atrial fibrillation (adjusted OR = 1.284 [1.025–1.607]), ventricular fibrillation (adjusted OR = 1.799 [1.406–2.301]), and acute renal failure (adjusted OR = 2.355 [1.902–2.917]). Patients who developed hypoglycemia were less likely to have PCI (OR = 0.596 [0.491–0.722]) but more likely to have CABG (OR = 1.792 [1.391–2.308]). They also had a longer in-hospital stay and higher charges/stay. Conclusion: Hypoglycemia is a rare event in patients hospitalized with STEMI. However, it was found to have higher odds of mortality, arrhythmias, and other comorbidities, irrespective of diabetes.

Original languageEnglish (US)
Article number940035
JournalFrontiers in Cardiovascular Medicine
Volume9
DOIs
StatePublished - Oct 10 2022
Externally publishedYes

Keywords

  • ST-elevation myocardial infarction
  • arrhythmias
  • cardiovascular disease
  • diabetes
  • hypoglycemia
  • mortality
  • myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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