A new study by Brazilian researchers has found that variations in blood sugar levels may help predict how much damage a heart attack causes, regardless of whether the patient has diabetes.
The findings, published in Diabetology & Metabolic Syndrome, suggest that a simple, inexpensive test could become an important tool for identifying patients at higher risk after their first heart attack.
The research focused on “glycemic delta,” which measures the difference between a patient’s blood sugar level when admitted to the hospital and their usual average level, calculated through a glycated hemoglobin (HbA1c) test.
A higher glycemic delta means the patient’s blood sugar upon arrival was much higher than their typical level.
The study followed 244 adults treated for acute myocardial infarction—the medical term for a heart attack—at Hospital São Paulo.
Thirty days after their heart attack, patients underwent magnetic resonance imaging (MRI) to assess heart muscle damage and heart function.
The results showed that people with higher glycemic deltas tended to have larger areas of damaged heart tissue and a lower left ventricular ejection fraction (LVEF). LVEF measures how effectively the heart pumps blood, and lower values are associated with heart failure.
“These findings were surprising and, as far as we know, unprecedented,” said cardiologist Henrique Tria Bianco, a professor at the Federal University of São Paulo and one of the study’s authors.
“We can now use a very simple test that almost every patient already has when admitted to the hospital—glycated hemoglobin—to identify those at risk of greater heart damage.”
Bianco and his colleagues noted that patients with higher glycemic deltas might benefit from closer monitoring and treatments aimed at protecting the heart, such as tighter glucose control and the use of medications like beta-blockers.
Heart attacks remain Brazil’s leading cause of death, with an estimated 300,000 to 400,000 cases each year. Roughly one in every five to seven cases is fatal. Heart attacks occur when blood flow to the heart muscle is suddenly blocked, usually by a blood clot.
Classic symptoms include severe, persistent chest pain that may spread to the arm, back, or face, often accompanied by sweating, shortness of breath, dizziness, or fainting. Rapid treatment in the first minutes is critical to reducing the risk of death.
In this study, all patients were over 18 and received clot-busting drugs (fibrinolytics) within six hours of symptom onset.
Many were first treated at public health clinics before being transferred to Hospital São Paulo. Some patients had diabetes, some had prediabetes, and others did not, but the association between glycemic delta and heart damage was consistent across all groups.
The researchers plan to test these results in larger and more diverse populations and to investigate the biological mechanisms behind the link.
They also hope to explore whether specific therapies could reduce the risks for patients with high glycemic deltas. Data on long-term patient survival from the study are expected to be published in the future.
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Source: KSR.
