FREQUENCY OF STRESS HYPERGLYCEMIA IN PATIENTS WITH ACUTE LEFT VENTRICULAR FAILURE

Background: Acute left ventricular failure (LVF) is a critical condition characterized by impaired cardiac output and pulmonary congestion. Stress hyperglycemia, defined as transient elevation in blood glucose in the absence of preexisting diabetes, is frequently observed in these patients. It results from neurohormonal activation and insulin resistance during acute physiological stress. The presence of stress hyperglycemia has been linked to adverse outcomes such as cardiogenic shock, increased mortality, and prolonged hospitalization. Timely recognition may assist in early risk stratification and improved clinical management. Objective: To determine the frequency of stress hyperglycemia in patients with acute left ventricular failure and identify associated risk factors. Methods: This descriptive study was conducted at the Department of Cardiology, MTI-Hayatabad Medical Complex, Peshawar, from September 1, 2024, to March 31, 2025. A total of 215 patients aged 18–80 years, diagnosed with acute LVF, were enrolled through sequential non-probability sampling. Patients with end-stage renal disease, liver dysfunction, pregnancy, pancreatitis, or infections were excluded. Blood glucose levels were recorded on admission and subsequently every 6 hours for 48 hours. HbA1c and echocardiographic LVEF were assessed at baseline. Data were analyzed using SPSS v23.0, with chi-square tests used for categorical associations and a significance threshold of p<0.05. Results: The mean age was 62.4 ± 14.2 years; 62.3% were male. Stress hyperglycemia was observed in 68.4% (n=147) of patients, peaking at 6 hours (70.7%, 162.4 ± 45.1 mg/dL) and declining to 48.8% by 48 hours (137.4 ± 32.1 mg/dL). A significantly higher prevalence was seen in patients aged 61–80 years (74.5%, p=0.033) and those with severely reduced LVEF <30% (76.4%, p=0.045). No significant associations were found with gender (p=0.172), BMI (p=0.210), or HbA1c (p=0.093). Conclusion: Stress hyperglycemia occurs in a majority of patients with acute LVF and is significantly associated with older age and severely impaired cardiac function. Its early detection is essential for clinical risk assessment and optimized management.