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Admission glycaemia and outcome in patients with acute coronary syndrome


Müdespacher, Damaris; Radovanovic, Dragana; Camenzind, Edoardo; Essig, Manfred; Bertel, Osmund; Erne, Paul; Eberli, Franz Robert; Gutzwiller, Felix (2007). Admission glycaemia and outcome in patients with acute coronary syndrome. Diabetes and Vascular Disease Research, 4(4):346-352.

Abstract

Some studies of patients with acute myocardial infarction have reported that hyperglycaemia at admission may be associated with a worse outcome. This study sought to evaluate the association of blood glucose at admission with the outcome of unselected patients with acute coronary syndrome (ACS).
Using the Acute Myocardial Infarction and unstable angina in Switzerland (AMIS Plus) registry, ACS patients were stratified according to their blood glucose on admission: group 1: 2.80–6.99 mmol/L, group 2: 7.00–11.09 mmol/L and group 3: > 11.10 mmol/L. Odds ratios for in-hospital mortality were calculated using logistic regression models.
Of 2,786 patients, 73% were male and 21% were known to have diabetes. In-hospital mortality increased from 3% in group 1 to 7% in group 2 and to 15% in group 3. Higher glucose levels were associated with larger enzymatic infarct sizes (p<0.001) and had a weak negative correlation with angiographic or echographic left ventricular ejection fraction. High admission glycaemia in ACS patients remains a significant independent predictor of in-hospital mortality (adjusted OR 1.08; 95% confidence intervals [CI] 1.05–1.14, p<0.001) per mmol/L. The OR for in-hospital mortality was 1.04 (95% CI 0.99–1.1; p=0.140) per mmol/L for patients with diabetes but 1.21 (95% CI 112–1.30; p<0.001) per mmol/L for non-diabetic patients.
In conclusion, elevated glucose level in ACS patients on admission is a significant independent predictor of in-hospital mortality and is even more important for patients who do not have known diabetes.

Abstract

Some studies of patients with acute myocardial infarction have reported that hyperglycaemia at admission may be associated with a worse outcome. This study sought to evaluate the association of blood glucose at admission with the outcome of unselected patients with acute coronary syndrome (ACS).
Using the Acute Myocardial Infarction and unstable angina in Switzerland (AMIS Plus) registry, ACS patients were stratified according to their blood glucose on admission: group 1: 2.80–6.99 mmol/L, group 2: 7.00–11.09 mmol/L and group 3: > 11.10 mmol/L. Odds ratios for in-hospital mortality were calculated using logistic regression models.
Of 2,786 patients, 73% were male and 21% were known to have diabetes. In-hospital mortality increased from 3% in group 1 to 7% in group 2 and to 15% in group 3. Higher glucose levels were associated with larger enzymatic infarct sizes (p<0.001) and had a weak negative correlation with angiographic or echographic left ventricular ejection fraction. High admission glycaemia in ACS patients remains a significant independent predictor of in-hospital mortality (adjusted OR 1.08; 95% confidence intervals [CI] 1.05–1.14, p<0.001) per mmol/L. The OR for in-hospital mortality was 1.04 (95% CI 0.99–1.1; p=0.140) per mmol/L for patients with diabetes but 1.21 (95% CI 112–1.30; p<0.001) per mmol/L for non-diabetic patients.
In conclusion, elevated glucose level in ACS patients on admission is a significant independent predictor of in-hospital mortality and is even more important for patients who do not have known diabetes.

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Additional indexing

Contributors:AMKS Plus Investigators
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2007
Deposited On:30 Mar 2009 06:38
Last Modified:05 Apr 2016 12:29
Publisher:Sherborne Gibbs
ISSN:1479-1641
Publisher DOI:https://doi.org/10.3132/dvdr.2007.063
PubMed ID:18158706

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