Admission glucose and left ventricular systolic function in non-diabetic patients with acute myocardial infarction

Joanna Gierach1, Marcin Gierach2, Iwona Świątkiewicz3

  • 1Department of Cardiology, Regional Specialist Hospital, Grudziadz, Poland. joanna.gierach@gmail.com.

Heart and Vessels
|December 26, 2014
PubMed

Insights

High admission glucose levels in patients with ST-segment elevation myocardial infarction (STEMI) but no carbohydrate disorders are linked to reduced left ventricular ejection fraction, indicating a poorer prognosis.

Area of Science:

  • Cardiology
  • Metabolic Disorders
  • Myocardial Infarction

Background:

  • Carbohydrate metabolism disorders in ST-segment elevation myocardial infarction (STEMI) patients correlate with adverse outcomes, particularly in non-diabetics.
  • These metabolic disturbances may negatively impact left ventricular (LV) function.

Purpose of the Study:

  • To investigate the effect of admission glucose levels on LV systolic function.
  • To assess LV function in the acute phase and 6 months post-myocardial infarction (MI) in STEMI patients without prior carbohydrate issues.

Main Methods:

  • Study included 52 STEMI patients (first MI, primary angioplasty, no history of diabetes or metabolic disorders).
  • Echocardiography assessed LV systolic function (ejection fraction) acutely and at 6 months post-MI.
  • Plasma glucose measured upon hospital admission.

Main Results:

  • Patients with admission glycemia ≥7.1 mmol/l showed significantly lower ejection fraction (EF) in the acute phase compared to those with <7.1 mmol/l (44.4% vs. 47.8%, p=0.04).
  • A trend towards lower EF was observed at 6 months post-MI in the higher glycemia group (47.2% vs. 50.3%, p=0.08).

Conclusions:

  • Elevated admission glucose in STEMI patients without diagnosed carbohydrate disorders may signify a worse prognosis.
  • This poorer prognosis is associated with diminished LV ejection fraction in both the acute and long-term phases after MI.

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