Diabetes mellitus and glucose as predictors of mortality in primary coronary percutaneous intervention

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Published on: June 11, 2012

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Renato Budzyn David1, Eduardo Dytz Almeida1, Larissa Vargas Cruz1

  • 1Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.

Arquivos Brasileiros De Cardiologia
|October 30, 2014
PubMed

Insights

Admission blood glucose is a stronger predictor of 30-day mortality in ST-elevation myocardial infarction patients undergoing primary PCI than a diabetes mellitus diagnosis. This highlights the critical role of glycemic control in cardiovascular outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes mellitus and admission blood glucose are known risk factors for mortality in ST-elevation myocardial infarction (STEMI) patients.
  • The independent and relative contributions of these factors to mortality remain debated.

Purpose of the Study:

  • To investigate the influence of diabetes mellitus and admission blood glucose on mortality in STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Main Methods:

  • A prospective cohort study included 740 STEMI patients undergoing primary PCI.
  • Data collected included clinical, angiographic, and laboratory parameters.
  • Multivariate analysis adjusted for GRACE score variables, with 30-day follow-up.

Main Results:

  • Diabetes mellitus prevalence was 18%.
  • Univariate analysis showed both diabetes and admission glucose predicted 30-day mortality.
  • Multivariate analysis revealed admission blood glucose as an independent predictor (RR 1.05, CI 1.02-1.09, p≤0.01), while diabetes mellitus did not (RR 2.41, CI 0.76-7.59, p=0.13).

Conclusions:

  • Admission blood glucose is a more accurate and robust predictor of 30-day mortality in STEMI patients post-primary PCI than a prior diabetes diagnosis.
  • This finding underscores the significant role of inflammation and glycemic status in patient outcomes.
Abstract

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