Stress-Induced Hyperglycemia After Hip Fracture and the Increased Risk of Acute Myocardial Infarction in Nondiabetic Patients
- Yan Chen, MD1,2,
- Xincun Yang, MD1⇑,
- Kang Meng, MD3⇑,
- Zechun Zeng, MD3,
- Baotong Ma, BPS4,
- Xingpeng Liu, MD1,
- Baoqing Qi, BPS2,
- Shuangshuang Cui, MPH4,
- Peihong Cao, MD4 and
- Yan Yang, BM2
- 1Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- 2Department of internal medicine, Tianjin Hospital, Tianjin, China
- 3Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- 4Department of Orthopedic Surgery, Tianjin Hospital, Tianjin, China
- Corresponding author: Xincun Yang, firstname.lastname@example.org, or Kang Meng, email@example.com.
OBJECTIVE To investigate the risk of acute myocardial infarction (AMI) following stress hyperglycemia after hip fracture.
RESEARCH DESIGN AND 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 d 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 d 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.
- Received January 16, 2013.
- Accepted April 29, 2013.
- © 2013 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.