Relationship between hyperglycaemia at admission and prognosis in patients with acute myocardial infarction: a

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Linlin Liu1, Jun Qian1, Wenwen Yan1

  • 1Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Postgraduate Medical Journal
|May 2, 2023
PubMed

Insights

High blood sugar on admission predicts higher mortality in acute myocardial infarction (AMI) patients, particularly those without diabetes. This finding highlights the importance of glucose management in AMI care.

Area of Science:

  • Cardiology
  • Endocrinology
  • Critical Care Medicine

Background:

  • The prognostic significance of admission hyperglycemia in acute myocardial infarction (AMI) remains incompletely understood.
  • Optimal glucose thresholds for risk stratification in AMI patients are not well-defined.

Purpose of the Study:

  • To determine the optimal admission blood glucose thresholds for predicting mortality in AMI patients.
  • To evaluate the impact of hyperglycemia on hospital and 1-year mortality in AMI patients, stratified by diabetes status.

Main Methods:

  • Retrospective analysis of 2027 AMI patients from the MIMIC-III database (June 2001-December 2012).
  • Receiver operating characteristic (ROC) curve analysis to identify significant blood glucose cut-off values (Glucose_0) for predicting hospital mortality.
  • Classification of patients into hyperglycemia and non-hyperglycemia groups based on identified thresholds.

Main Results:

  • Admission hyperglycemia was associated with significantly increased hospital mortality in AMI patients, irrespective of diabetes status.
  • For AMI patients without diabetes, hyperglycemia independently predicted increased 1-year mortality (HR, 1.47; 95% CI 1.18-1.82).
  • The association between hyperglycemia and 1-year mortality was not significant in AMI patients with diabetes (HR, 1.35; 95% CI 0.93-1.95).

Conclusions:

  • Admission hyperglycemia serves as an independent predictor of mortality in patients with AMI.
  • The prognostic impact of admission hyperglycemia is more pronounced in AMI patients without a history of diabetes.
  • These findings underscore the importance of monitoring and managing blood glucose levels in AMI patients for improved clinical outcomes.
Abstract

Keywords:
adult cardiologyadult intensive & critical carecoronary heart diseasediabetes & endocrinologymyocardial infarction

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