Hypoglycemia and acute coronary syndrome

Czech version

Authors: Tomáš Bolek; Matej Samoš; Peter Galajda; Marián Mokáň
Authors‘ workplace: I. Interná klinika JLF UK a UN Martin
Published in: Forum Diab 2020; 9(1): 33-37
Category:

Overview

Diabetes mellitus is an important risk factor of acute coronary syndrome. Good glycemic control can reduce the incidence of long-term diabetic complications however it can be associated with episodes of hypoglycemia. The hypoglycemia increases the risk of cardiovascular adverse events (e.g. ACS) furthermore increases the cardiovascular mortality in patients with ACS. Also, hypoglycemia can negatively affect hemodynamic parameters, myocardial ischemia, electrical stability of cardiomyocytes, hemostasis in patients with ACS. This article reviews the current knowledge about the association of hypoglycemia and patient outcomes in ACS.

Keywords:

hypoglycemia – acute coronary syndrome

Sources

Mokáň M, Galajda P. Hypoglykémia ako rizikový kardiovaskulárny faktor. Forum Diab 2014; 3(1): 20–27.
Turchin A, Matheny ME, Shubina M et al. Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care 2009; 32(7): 1153–1157. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08–2127>.
Mokáň M, Galajda P: Hypoglykémia pri vybraných vnútorných chorobách. Quickprint: Martin 2011. ISBN 978–80–970660–6-2.
Bedenis R, Price AH, Robertson CM et al Association between severe hypoglycemia, adverse macrovascular events, and inflammation in the Edinburgh Type 2 Diabetes Study. Diabetes Care 2014; 37(12):3301–3308. Dostupné z DOI: <http://dx.doi.org/10.2337/dc14–0908>.
Bonds DE, Miller ME, Bergenstal RM et al. The association between symptomatic severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ 2010; 340:b4909. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.b4909>.
Zhang JW, Zhou YJ. Association of silent hypoglycemia with cardiac events in non-diabetic subjects with acute myocardial infarction undergoing primary percutaneous coronary interventions. BMC Cardiovasc Disord 2016; 16:75. Dostupné z DOI: <http://dx.doi.org/10.1186/s12872–016–0245-z>.
Svensson AM, McGuire DK, Abrahamson P et al. Association between hyper- and hypoglycaemia and 2 year all-cause mortality risk in diabetic patients with acute coronary events. Eur J Heart 2005; 26(13): 1255–1261. Dostupné z DOI: <https://doi.org/10.1093/eurheartj/ehi230>.
Nishioka Y, Okada S, Noda et al. Absolute risk of acute coronary syndrome after severe hypoglycemia: A population-based 2-year cohort study using the National Database in Japan. J Diabetes Investig 2019. Dostupné z DOI: <http://dx.doi.org/10.1111/jdi.13153>.
Fisher BM, Gillen G, Dargie HJ et al. The effects of insulin-induced hypoglycemia on cardiovascular function in normal man: studies using radionuclide ventriculography. Diabetologia 1987; 30(11): 841–845. Dostupné z DOI: <http://dx.doi.org/10.1007/bf00274791>.
Airaksinen J, Lahtela JT, Ikaheimo MJ et al. Intravenous insulin has no effect on myocardial contractility or he rate in healthy subjects. Diabetologia 1985; 28(9): 649–652. Dostupné z DOI: <http://dx.doi.org/10.1007/bf00291969>.
Hoffman RP. Sympathetic mechanism of hypoglycemic counterregulation. Curr Diabetes Rev 2007; 3(3): 185–193. Dostupné z DOI: <http://dx.doi.org/10.1007/10.2174/157339907781368995>.
Dungan KM, Binkley P, Nagaraja HN et al. The impact of glycemic control and glycemic variability on mortality in patients hospitalized with congestive heart failure. Diabetes Metab Res Rev 2011; 27(1): 85–93. Dostupné z DOI: <http://dx.doi.org/10.1002/dmrr.1155>.
Lindstrom T, Jorfeldt L, Tegler L et al. Hypoglycaemia and cardiac arrhythmias in patients with type 2 diabetes mellitus. Diab Med 1992; 9(6): 536–541. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.1992.tb01834.x>.
Nordin C. The case of hypoglycaemia as a proarrythmic event: basic and clinical evidence. Diabetologia 2010; 53(8): 1552–1561. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–010–1752–6>.
Gill GV, Woodward A, Casson IF et al. Cardiac arrythmia and nocturnal hypoglycaemia in type 1 diabetes – the „dead in bed“ syndrome revisited. Diabetologia 2009; 52(1): 42–45. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–008–1177–7>.
Eckert B, Agardh CD. Hypoglycaemia leads to an increased QT interval in normal men. Clin Physiol 1998; 18(6): 570–575. Dostupné z DOI: <http://dx.doi.org/10.1046/j.1365–2281.1998.00138.x>.
Robinson RT, Harris ND, Ireland RH et al. Changes in cardiac repolarization during clinical episoes of nocturnal hypoglycaemia in adults with type 1 diabetes. Diabeteologia 2004; 47(2): 312–315. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–003–1292–4>.
Pollock G, Brady WJ, Hargarten S et al.: Hypoglycemia manifested by sinus bradycardia: A report of three cases. Acad Emerg Med.1996; 3(7): 700–707. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1553–2712.1996.tb03495.x>.
Pladziewicz DS, Nesto RW. Hypoglycemia-induced silent myocardial ischemia. Am J Cardiol 1989; 63(20): 1531–1532. Dostupné z DOI: <http://dx.doi.org/10.1016/0002–9149(89)90025–8>.
Samoš M, Kovář F, Galajda P et al. Diabetes mellitus a akútny koronárny syndróm. Quickprint: Martin 2015. ISBN 978–80–970969–6-0.
Duh E, Feinglos M. Hypoglycemia-induced angina pectoris in a patient with diabetes mellitus. Ann Intern Med 1994; 121(12): 945–946. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–121–12–199412150–00007>.
Desouza C, Salazar H, Cheong B et al. Association of hypoglycemia and cardiac ischemia – A study based on continuous monitoring. Diabetes Care 2003; 26(5): 1485–1489. Dostupné z DOI: <http://dx.doi.org/10.2337/diacare.26.5.1485>.
Fisher BM, Frier BM. Effect on vascular disease. In: Frier BM, Fisher BM (eds). Hypoglycaemia and Diabetes. Edward Arnold: London 1992: 355–360.
Dalsgaard-Nielsen J, Madsbad S, Hilsted. Changes in platelet function, blood coagulation and fibrinolysis during insulin-induced hypoglycemia in juvenile diabetics and normal subjects. Thromb Haemost 1982; 47(3): 254–258.
Hutton RA, Mikhailidis D, Dormandy M et al. Platelet aggregation studies during transient hypoglycemia. J Clin Pathol 1979; 32(5): 434–438. Dostupné z DOI: <http://dx.doi.org/10.1136/jcp.32.5.434>.
Coller BS, Frank RN, Milton RC et al.: Plasma co-factors of platelet function: correlation with diabetes retinopathy and Hb, a-c. Am Intern Med 1978; 88(3): 311–316. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–88–3-311>.
Fisher BM, Quin JD, Rumley A et al. Effects of acute insulin-induced hypoglycaemia on haemostasis, fibrinolysis and haemorheology in insulin dependent diabetic patients and control subjects. Clin Sci 1991; 80(5): 525–531. Dostupné z DOI: <http://dx.doi.org/10.1042/cs0800525>.
Corrall RJ, Webber RG, Frier BM. Increase in coagulation factor VIII activity in man following acute hypoglycemia: mediation via an adrenergic mechanism. Br J Hematol 1980; 44(2): 301–305. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2141.1980.tb01212.x>.
Wright RJ, Newby DE, Stirling D et al. Effects of acute insulin-induced hypoglycemia on indices of inflammation: putative mechanism for aggravating vascular disease in diabetes. Diabetes Care 2010; 33(7): 1591–1597. Dostupné z DOI: <http://dx.doi.org/10.2337/dc10–0013>.
Gogitidze JN, Hedrington MS, Briscoe VJ et al. Effects of acute hypoglycemia on inflammatory and pro-atherothrombotic biomarkers in individuals with type 1 diabetes and healthy individuals. Diabetes Care 2010; 33(7): 1529–1535. Dostupné z DOI: <http://dx.doi.org/10.2337/dc09–0354>. Erratum in Diabetes Care 2010; 33(9): 2129.
Dantz D, Bewersdorf J, Fruehwald-Schultes B et al. Vascular endothelial growth factor: a novel endocrine defensive response to hypoglycemia. J Clin Endocrin Metab 2002; 87(2): 835–840. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem.87.2.8215>.
Dotson S, Freeman R, Failing HJ et al. Hypoglycemia increases serum interleukin-6 levels in healthy men and women. Diabetes Care 2008; 31(6): 1222–1223. Dostupné z DOI: <http://dx.doi.org/10.2337/dc07–2243>.
Hilsted J, Bonde-Peterson F, Madsbad S et al.: Changes in plasma volume, in transcapillary escape rate of albumin and in subcutaneous blood flow during hypoglycemia in man. Clinic Science 1985; 69(3): 273–277. Dostupné z DOI: <http://dx.doi.org/10.1042/cs0690273>.
Wieczorek I, Pell ACH, McIver B et al. Coagulation and fibrinolytic systems in type 1 diabetes: effects of venous occlusion and insulin-induced hypoglycaemia. Clin Sci 1993; 84(1): 79–86. Dostupné z DOI: <http://dx.doi.org/10.1042/cs0840079>.