Modenesi Renata de Faria, Pena Felipe Montes, Faria Carlos Augusto Cardoso de, Carvalho Ricardo Viana, Souza Nelson Robson Mendes de, Soares Jamil da Silva, Mesquita Evandro Tinoco
Universidade Federal Fluminense - UFF -Niterói (RJ), Brazil.
Rev Bras Ter Intensiva. 2012 Dec;24(4):352-6. doi: 10.1590/s0103-507x2012000400010.
To demonstrate the prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome and to determine the correlation of stress hyperglycemia with death, heart failure and/or left ventricular systolic dysfunction during the intrahospital phase.
A prospective initial cohort study of hospitalized patients with acute coronary syndrome with or without ST segment elevation. The groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular events. The chi-square test or Fisher's exact test and student's t-test were used to compare the groups with and without stress hyperglycemia. The variables with p<0.20 in the univariate analysis were submitted to logistic regression.
In total, 363 patients with an average age of 12.45 ± 62.06 were studied. There was a predominance of males (64.2%). In total, 96 patients (26.4%) presented with stress hyperglycemia. There were no differences between the groups with or without stress hyperglycemia. The area under the ROC curve was 0.67 for the relationship between stress hyperglycemia and the composite outcome heart failure, left ventricular systolic dysfunction or death at the end of the hospital admission. The ROC curve proved that stress hyperglycemia was the predictor of the composite outcome (death, heart failure and/or ventricular dysfunction). The multivariate analysis did not indicate age, stress hyperglycemia or admission heart rate as risk factors.
Stress hyperglycemia was common in the studied sample. In the univariate analysis, the presence of stress hyperglycemia was associated with such events as death, heart failure and/or intrahospital ventricular dysfunction in patients with acute coronary syndrome.
在一组急性冠脉综合征患者中证明应激性高血糖的患病率，并确定应激性高血糖与住院期间死亡、心力衰竭和/或左心室收缩功能障碍的相关性。
对有或无ST段抬高的急性冠脉综合征住院患者进行前瞻性初始队列研究。比较各研究组以证明应激性高血糖与心血管事件之间的相关性。采用卡方检验或Fisher精确检验以及学生t检验对有或无应激性高血糖的组进行比较。单因素分析中p<0.20的变量进行逻辑回归分析。
共研究了363例平均年龄为12.45±62.06岁的患者。男性占多数（64.2%）。共有96例患者（26.4%）出现应激性高血糖。有或无应激性高血糖的组之间无差异。应激性高血糖与住院末期心力衰竭、左心室收缩功能障碍或死亡的复合结局之间关系的ROC曲线下面积为0.67。ROC曲线证明应激性高血糖是复合结局（死亡、心力衰竭和/或心室功能障碍）的预测指标。多因素分析未显示年龄、应激性高血糖或入院心率为危险因素。
在所研究的样本中应激性高血糖很常见。在单因素分析中，应激性高血糖的存在与急性冠脉综合征患者的死亡、心力衰竭和/或住院期间心室功能障碍等事件相关。
