ArticlePloS one2025
Diabetic ketoacidosis and hyperglycemic hyperosmolar state are associated with higher in-hospital mortality and morbidity in diabetes patients hospitalized with ST-elevation myocardial infarction, but not within 30 days of readmission.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Predictors of In-Hospital Mortality in Patients With Type 2 Diabetes Complicated by Isolated Hyperosmolar Hyperglycemic Syndrome.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Mapping the storm: a scoping review of diabetic emergencies in Africa.Frontiers in clinical diabetes and healthcare · 2026Review
- Outcomes following hospitalization for diabetic ketoacidosis in patients with cardiovascular disease.Endocrine connections · 2025Article
- The prognostic significance of stress hyperglycemia ratio in evaluating all-cause and cardiovascular mortality risk among individuals across stages 0-3 of cardiovascular-kidney-metabolic syndrome: evidence from two cohort studies.Cardiovascular diabetology · 2025Article
- Inverse Association Between the Dawn Phenomenon and Thyroid Feedback Quantile-Based Index in Type 2 Diabetes Using Continuous Glucose Monitoring: A Cross-Sectional Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
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Abstract
backgroundWhile the cardiovascular risk of hyperglycemia has been thoroughly elucidated in patients with type 2 diabetes (T2DM) hospitalized for myocardial infarction, the evidence surrounding acute severe hyperglycemia is less well-established. Our study aimed to explore the impact of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS), both severe hyperglycemic conditions, on cardiovascular outcomes in patients with T2D admitted for ST-elevation myocardial infarction (STEMI).
methodsWe used the National Readmission Database (2016-2019) to extract patients with T2DM and STEMI at baseline. Subsequently, we selected cases of DKA and HHS. The primary endpoint was in-hospital mortality. Secondary endpoints included in-hospital acute renal failure, cardiogenic shock, and 30-day readmission and mortality.
resultsThe presence of DKA increased the adjusted odds of mortality and cardiogenic shock by almost 2-fold (adjusted Odds Ratios aOR = 2.30 [1.70-3.12], 2.055 [1.602-2.637], respectively) and renal failure by nearly 5-fold (aOR = 5.175 [4.090-6.546]). HHS was also associated with higher odds of mortality, acute renal failure, and cardiogenic shock. In 30 days, DKA and HHS increased the risk of readmission (aOR = 1.815 [1.449-2.75], 1.751 [1.376-2.228], respectively). There were no differences in the rates of cardiovascular disease, mortality, or other cardiovascular events between DKA and HHS patients. Within 30 days of readmission, DKA and HHS were associated with higher odds of readmission but not mortality. Cardiovascular disease was the most common etiology of readmission in all patients. The incidence of non-STEMI was the highest in DKA patients, and the incidence of STEMI was the highest in the HHS group.
conclusionThe presence of diabetic ketoacidosis or hyperglycemic hyperosmolar state is associated with higher odds of mortality, renal failure, cardiogenic shock, and 30-day readmission in STEMI patients with type 2 diabetes, highlighting the need for enhanced clinical management and monitoring of patients experiencing acute hyperglycemia.
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