Alterations of stress hormone and glucose level and their prognostic value in senile patients with acute myocardial infarction

Objective To investigate the alterations of stress hormones and glucose level and their prognostic value in senile patients with acute myocardial infarction. Methods A total of 106 non-diabetics patients (≥60 years old) with ST segment elevation myocardial infarction (STEMI) were divided into 2 groups according to serum glucose(SG)levels on admission:Non-stress hyperglycemia group, SG7.8 mmol/L (n=63), Stress hyperglycemia group,SG≥7.8 mmol/L (n=43). Stress hyperglycemia was defined as random SG levels greater than or equal to 7.8 mmol/L on admission. We compared the clinical data and stress hormones(Cortisol, growth hormone, Insulin, glucagons, adrenocorticotropic hormone [ACTH]), and investigated heart failure, reinfarction, post-infarction angina, serious arrhythmias, and cardiac death in the 2 groups. Results The incidence of stress hyperglycemia was 40.6% in the present study.The stress hormone levels in the stress hyperglycemia group were significantly higher than those in the non-stress hyperglycemia group (P0.01). The insulin level in the stress hyperglycemia group was much lower than that of non-stress hyperglycemia group (P0.01). The incidences of heart failure, reinfarction, post-infarction angina, serious arrhythmias, and cardiac death in the stress hyperglycemia group were markedly higher than those of non-stress hyperglycemia group (P0.05). The left ventricular ejection fraction in stress hyperglycemia group was markedly lower than that in the non-stress hyperglycemia group (0.488 4±0.073 7 vs. 0.540 5±0.062 4, P0.05). Conclusion Aberrantly high blood glucose and stress hormones on admission are associated with a poor prognosis (within 30 days after onset) in senile patients with acute myocardial infarction.