Titre du document / Document title

Glucose dysregulation in nondiabetic patients with ST-elevation myocardial infarction : acute and chronic glucose dysregulation in STEMI

Auteur(s) / Author(s)

RASOUL S. ⁽¹⁾ ; OTTERVANGER J. P. ⁽¹⁾ ; BILO H. J. G. ⁽²⁾ ; TIMMER J. R. ⁽¹⁾ ; VAN 'T HOF A. W. J. ⁽¹⁾ ; DAMBRINK J. H. E. ⁽¹⁾ ; DIKKESCHEI L. D. ⁽³⁾ ; HOORNTJE J. C. A. ⁽¹⁾ ; DE BOER M. J. ⁽¹⁾ ; ZIJLSTRA F. ⁽⁴⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Cardiology, Isala Clinics, PO Box, 10500, 8000 CM Zwolle, PAYS-BAS
⁽²⁾ Department of Internal Medicine, Isala Clinics, PO Box, 10500, 8000 CM Zwolle, PAYS-BAS
⁽³⁾ Department of Laboratory Medicine, Isala Clinics, PO Box, 10500, 8000 CM Zwolle, PAYS-BAS
⁽⁴⁾ University Medical Centre, Groningen, PAYS-BAS

Résumé / Abstract

Background: Admission hyperglycaemia is associated with an increased risk of mortality after myocardial infarction. Whether long-term glucose dysregulation (assessed by HbAic) is more important than acute hyperglycaemia is unknown. We evaluated the prognostic value of admission glucose and HbAIC levels in nondiabetic patients with ST-segment elevation acute myocardial infarction (STEMI). Methods: In 504 unselected, consecutive patients with STEMI, glucose and HbAic levels were measured on admission. Glucose was categorised as <II.I mmol/l (n=422) and ≥II.I mmol/l (n=82). HbAic levels were categorised as <6.o% (n=416) and ≥6.0% (n=88). Mean follow-up was 1.6±0.6 years. Results: Patients with hyperglycaemia on admission were comparable with those with normoglycaemia. However, patients with HbAic a6.o%, as compared with those with HbAIC <6%, were older, were more often on β-blockers and more frequently had multivessel disease. Thirty-day mortality in the subsequent glucose categories (<II.I mmol/l and ≥II.I mmol/l) was 4% and 19% (p<o.ooi) and in the subsequent HbAic categories (<6% and a6%) was 5% and 12% (p=0.03). After multivariable analyses, admission glucose (OR 4.91, 95% CI 2.03 to 11.9, p< 0.001) but not HbAic (OR 1.33, 95% CI 0.48 to 3.71, p=0.58) was significantly associated with 30-day mortality. Among 30-day survivors, neither admission glucose nor HbAic were predictors of long-term mortality. Conclusion: Elevated admission glucose is an important predictor of 30-day outcome after STEMI, while prior long-term glucose dysregulation is a covariate of other high-risk clinical characteristics. Among 30-day survivors, neither admission blood glucose nor HbAic were predictors of long-term outcome.

Revue / Journal Title

Netherlands journal of medicine   ISSN 0300-2977 

Source / Source

2007, vol. 65, n^o3, pp. 95-100 [6 page(s) (article)] (35 ref.)

Langue / Language

Anglais

Editeur / Publisher

Van zuiden, Alphen aan den Rijn, PAYS-BAS  (1973) (Revue)

Mots-clés anglais / English Keywords

Heart disease ; Myocardial disease ; Cardiovascular disease ; Medicine ; Prognosis ; Evolution ; Hemoglobin A1c ; Chronic ; Acute ; ST elevation ; Patient ; Human ; Glucose ; Myocardial infarction ;

Mots-clés français / French Keywords

Cardiopathie ; Myocarde pathologie ; Appareil circulatoire pathologie ; Médecine ; Pronostic ; Evolution ; Hémoglobine A1c ; Chronique ; Aigu ; Susdécalage ST ; Malade ; Homme ; Glucose ; Infarctus myocarde ;

Mots-clés espagnols / Spanish Keywords

Cardiopatía ; Miocardio patología ; Aparato circulatorio patología ; Medicina ; Pronóstico ; Evolución ; Hemoglobina A1c ; Crónico ; Agudo ; ST elevación(ECG) ; Enfermo ; Hombre ; Glucosa ; Infarto miocardio ;

Mots-clés d'auteur / Author Keywords

ST-elevation acute myocardial infarction ; admission glucose ; HbAic ; outcome ;

Localisation / Location

INIST-CNRS, Cote INIST : 17581, 35400014344718.0030