Glucose Level Fluctuations as Indicators of Heart Attack Severity

Recent research conducted by Brazilian scientists indicates that variations in blood glucose levels can serve as valuable biomarkers for assessing the severity of damage following a first-time acute myocardial infarction (heart attack). The study highlights that not only the absolute blood glucose levels but also the degree of fluctuation—specifically, the glycemic delta—are linked to the extent of heart muscle damage and subsequent cardiac function.

The research, involving 244 patients treated at Hospital São Paulo, found that higher glycemic delta values correlated with larger infarct sizes and a reduction in left ventricular ejection fraction (LVEF), which measures the heart's pumping efficiency. Importantly, this association was observed regardless of the diabetes status of the patients. The glycemic delta is calculated by subtracting the estimated average blood glucose (based on HbA1c tests) from the admission blood glucose level, offering an easy and cost-effective method for risk stratification.

In addition, magnetic resonance imaging performed 30 days post-heart attack revealed connection between glycemic variability and muscle loss as well as myocardial damage. These findings, published in the journal Diabetology & Metabolic Syndrome, open up new avenues for prognosis and management of heart attack patients. According to lead author and cardiologist Henrique Tria Bianco, the discovery was unexpected and provides an opportunity for further understanding of the pathways involved in myocardial injury.

The study underscores the potential of using routine blood tests, such as glycated hemoglobin, as simple biomarkers to identify high-risk individuals who may benefit from intensified therapies. As acute myocardial infarction remains the primary cause of death in Brazil—with an estimated 300,000 to 400,000 cases annually—improving risk assessment tools like glycemic delta could significantly impact patient outcomes.

The research also points to future investigations focused on unraveling cellular mechanisms and developing targeted treatments to mitigate damage in high-risk groups. Overall, this study reinforces the importance of blood glucose management during heart attack episodes and could influence clinical strategies to improve survival and reduce cardiac complications.