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Predictive value of admission hyperglycaemia on mortality in patients with acute myocardial infarction

F Schiele1, V Descotes-Genon, M F Seronde

  • 1Department of Cardiology, University Hospital Jean-Minjoz, Besançon, France. francois.schiele@ufc-chu.univ-fcomte.fr

Diabetic Medicine : a Journal of the British Diabetic Association
|November 23, 2006
PubMed

Insights

Admission hyperglycemia (AH) in acute myocardial infarction patients significantly increases 1-year mortality risk, comparable to those with diabetes. This elevated risk persists even after accounting for risk scores and guideline-recommended treatments.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Admission hyperglycemia (AH) is a known risk factor for mortality in acute myocardial infarction (AMI).
  • The independent predictive value of AH, considering risk scores and treatment, requires further clarification.

Purpose of the Study:

  • To evaluate the prognostic impact of AH on 1-year mortality in AMI patients.
  • To compare the mortality risk associated with AH to that of pre-existing diabetes.

Main Methods:

  • Fasting plasma glucose levels, risk scores (GRACE), guideline-recommended treatment use, and 1-year mortality were recorded.
  • Patients were categorized into groups: pre-existing diabetes, AH (glucose > 7.7 mmol/l), and neither.

Main Results:

  • AH was present in 21% of patients; mortality was 18.8% in the AH+ group versus 6.1% in the AH- group (P < 0.01).
  • Mortality in the AH+ group was similar to the diabetes group (18.8% vs. 16.6%).
  • AH remained a significant predictor of mortality after adjusting for GRACE risk score and treatment score.

Conclusions:

  • In non-diabetic AMI patients, AH signifies an elevated 1-year mortality risk.
  • This risk is comparable to that observed in patients with pre-existing diabetes, independent of risk stratification and treatment.
Abstract

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