Admission glucose level and in-hospital outcomes in diabetic and non-diabetic patients with acute myocardial infarction

Clin Res Cardiol. 2010 Nov;99(11):715-21. doi: 10.1007/s00392-010-0175-1. Epub 2010 May 11.

Abstract

Background: Hyperglycemia on admission is a predictor of unfavorable prognosis in patients with acute myocardial infarction (AMI). Data concerning associations between elevated glucose level on admission and other in-hospital complications are still limited.

Methods: A total of 607 AMI patients with complete admission glucose data in the Krakow Registry of Acute Coronary Syndromes were identified and were stratified according to glucose admission level.

Results: A total of 71.5% of patients were with admission glucose level <7.8 mmol/l, 17.6% of patients with 7.8-11.0 mmol/l, and 10.9% of patients with ≥11.1 mmol/l. In-hospital mortality for patients treated conservatively was higher in patients with higher admission glucose (8.0 vs. 25.0 vs. 39.1%, respectively, P < 0.0001), and significant mortality difference was confirmed both for diabetic and non-diabetic patients. Admission hyperglycemia was associated with increased risk of ventricular tachycardia/ventricular fibrillation, atrial fibrillation, second to third atriventricular block, pulmonary oeadema, but not ischemic stroke and blood transfusion during index hospital stay.

Conclusions: Elevated admission glucose levels are associated with increased risk of life-threatening complications, especially arrhythmias in diabetic and non-diabetic AMI patients. This increased risk of complications is one of the possible explanations for the elevated in-hospital mortality in AMI patients presenting with hyperglycemia.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Blood Glucose / metabolism*
  • Diabetes Mellitus / blood*
  • Diagnostic Tests, Routine / methods*
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / complications
  • Inpatients*
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality
  • Poland / epidemiology
  • Prognosis
  • Prospective Studies
  • Risk Factors

Substances

  • Blood Glucose