Association between Hyperglycemic Crisis with Major Cardiovascular Events in Patients with Diabetes: A Single Center Retrospective Cohort Study

Introduction: Hyperglycemic crisis caused by an increase of insulin requirement and one of the predisposing factors are cardiovascular disease; this condition can induce an increasing cytokine which also acts as a coronary heart disease marker. The latest study remains unclear about the association with cardiovascular outcomes. This study aimed to investigate the association between hyperglycemic crisis and major adverse cardiovascular events (MACEs). Materials and methods: This study is an analytical study with cohort retrospective design conducted at Sanglah General Hospital from February until April 2019. The data was taken using the total sampling method; 126 samples were collected from the medical record with 43 samples hyperglycemic crisis as a case group and non-hyperglycemic crisis as a control group with 83 samples according to inclusion and exclusion criteria — the analysis using univariate and bivariate survival analysis. The primary outcome was the risk ratio. Results: The median age in this study was 45.69 years old (SD 2.53) for the case group and control 55.73 ± 1.21 years old. The gender ratio between males and females in both groups is 1:1–2; the mean of HbA1c in the case group is higher than the control group, 12.06 ± 3.06 vs. 7.9 (5.1–14.8) %. Relative risk analysis between hyperglycemic crisis and MACE is obtained RR 5.576 with 95% CI: 2.87–10.8 and p-value = 0.000 with potential confounding variable are not associated.  Conclusions: There is a significant association between hyperglycemic crisis and MACE statistically