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Plasma glucose and not hemoglobin or renal function predicts mortality in patients with STEMI complicated with

Marije M Vis1, Annemarie E Engström, Krischan D Sjauw

  • 1Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|August 6, 2010
PubMed

Insights

Admission glucose levels strongly predict 1-year mortality in ST-segment elevation myocardial infarction (STEMI) patients with cardiogenic shock. Hemoglobin and creatinine clearance showed no prognostic value in this high-risk group.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Critical Care Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock is a leading cause of death.
  • Hyperglycemia, anemia, and kidney dysfunction are known poor prognostic indicators in STEMI.
  • Limited data exist on the combined predictive value of these factors in STEMI with cardiogenic shock.

Purpose of the Study:

  • To evaluate the prognostic significance of admission glucose, hemoglobin, and creatinine clearance in STEMI patients experiencing cardiogenic shock.
  • To identify independent predictors of 1-year mortality in this vulnerable patient population.

Main Methods:

  • Retrospective analysis of 3038 STEMI patients treated with percutaneous coronary intervention (PCI) between 1997 and 2005.
  • Focus on 292 patients who presented with cardiogenic shock.
  • Multivariate logistic regression analysis to assess the predictive value of glucose, hemoglobin, and creatinine clearance for 1-year mortality.

Main Results:

  • Overall 1-year mortality was 34% in the cardiogenic shock cohort.
  • Admission glucose levels were a significant independent predictor of mortality.
  • Each 1 mmol/l increase in glucose was associated with an 11% increase in mortality odds (OR 1.11, P = 0.013).

Conclusions:

  • Admission glucose levels are a strong and independent predictor of 1-year mortality in STEMI patients with cardiogenic shock treated with PCI.
  • Hemoglobin and creatinine clearance do not appear to have prognostic value in this specific patient group.
Abstract

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