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Impact of Admission Glucose on Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction Treated with
Zhen-Xuan Hao1, Yang Liu1, Dan-Li Wang1
1Department of Cardiology, People's Hospital of Zhengzhou, Southern Medical University, Zhengzhou 450000, China.
Insights
High admission glucose levels significantly increase early and late mortality risk in ST-segment elevation myocardial infarction (STEMI) patients. This meta-analysis confirms impaired glucose as a key prognostic marker for adverse outcomes.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Impaired admission glucose (AG) is a potential risk factor for mortality in ST-segment elevation myocardial infarction (STEMI).
- Previous studies show conflicting results regarding the association between AG and STEMI outcomes, particularly in non-diabetic patients.
- This meta-analysis investigates the relationship between impaired AG and mortality risk in STEMI.
Purpose of the Study:
- To evaluate the association between impaired admission glucose and the risk of early and late death in STEMI patients.
- To clarify the prognostic value of admission glucose levels in STEMI, considering both diabetic and non-diabetic populations.
- To provide a quantitative assessment of mortality risk based on admission glucose concentrations.
Main Methods:
- Systematic literature search of PubMed, EMBASE, Web of Science, and Cochrane Library for prospective cohort studies.
- Quantitative meta-analysis to pool relative risks (RRs) and 95% confidence intervals (CIs).
- Inclusion of studies reporting on admission glucose levels and mortality outcomes in STEMI patients.
Main Results:
- Elevated admission glucose (≥ 6.1-11.1 mmol/L) was associated with a 4.38-fold higher risk of early mortality (95% CI, 3.23-5.94).
- For late mortality, glucose levels ≥ 7.8-11.1 mmol/L showed a 2.69-fold increased risk in the full participant group (95% CI, 2.16-3.34).
- Among in-hospital or 30-day survivors, high admission glucose indicated a 1.65-fold higher risk of late mortality (95% CI, 1.33-2.04).
Conclusions:
- Impaired admission glucose is a significant prognostic marker for increased early mortality in STEMI.
- High admission glucose levels also demonstrate a distinct, albeit poorer, prognostic impact on long-term mortality compared to early mortality.
- These findings underscore the importance of monitoring admission glucose for risk stratification in STEMI patients.
Background:
Impaired admission glucose (AG) is thought to significantly increase the risk of both early and late death with ST-segment elevation myocardial infarction (STEMI), especially for non-diabetic patients. However, several earlier studies contradict these relationships. Through our meta-analysis, we aimed to evaluate such a relation between impaired AG, the risk of death and STEMI.
Methods:
We accessed PubMed, EMBASE, Web of Science, and the Cochrane Library and systematically searched their databases to identify all related prospective cohort studies. The relative risks (RRs) with their 95% confidence interval (CI) were pooled quantitatively.
Results:
The pooled, unadjusted relative risks of early outcome events indicated that patients who had glucose concentrations ≥ the range of 6.1-11.1 mmol/L, had a 4.38-fold (95% CI, 3.23-5.94) higher early mortality. For late outcome events, the pooled unadjusted RR indicated patients who had glucose concentrations ≥ the range 7.8-11.1 mmol/L, and had a 2.69-fold (95% CI, 2.16-3.34) higher late mortality based on full participants, whereas patients had a 1.65-fold (95% CI, 1.33-2.04) higher late mortality based on based on in-hospital or 30-day survivors.
Conclusions:
In conclusion, the present meta-analysis demonstrated that impaired admission glucose may be an effective prognostic marker for significantly increased risk of early death. Regarding the long-term outcomes based on full population or early survival, high admission glucose also has a distinct but poorer prognostic impact on long-term mortality than early mortality.
Key Words:
Admission glucose • Meta-analysis • Myocardial infarction • Non-diabetic.
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