Stress hyperglycemia leads to worse outcomes in patients with acute type A aortic dissection

For this purpose, the researchers consecutively enrolled 1098 patients with a confirmed ATAAD diagnosis. Patients were divided in accordance to the admission blood glucose (BG) into the normoglycemia group (BG < 7.8 mmol/L), mild to moderate SIH group (7.8 ≤ BG < 11.1 mmol/L) and severe SIH group (BG ≥ 11.1 mmol/L). The association between SIH and mortality risk was determined using Multivariate regression analysis.

The study led to the following findings:

· There were 38.3% ATAAD patients with SIH, including 32.9% cases in the mild to moderate group and 5.46% cases in the severe group.

· The proportion of high-risk clinical manifestations and conservative treatment was greater in the SIH group than in the normoglycemia group.

· Severe SIH was associated with a high risk of 30-day (OR: 3.773) and 1-year mortality risk (OR: 3.522).

"Approximately 40% of the patients with ATAAD had SIH and were more likely to present with high-risk clinical features and receive non-surgical treatment," the researchers wrote.

"Severe SIH could be used as an independent predictor of increased risk of short-term and long-term mortality and reflect the disease severity of ATAAD," they concluded.

Reference:

Liu S, Song C, Cui K, Bian X, Wang H, Fu R, Zhang R, Yuan S, Dou K. Prevalence and prognostic impact of stress-induced hyperglycemia in patients with acute type A aortic dissection. Diabetes Res Clin Pract. 2023 Jul 5;203:110815. doi: 10.1016/j.diabres.2023.110815. Epub ahead of print. PMID: 37419392.