[Effect of admission blood glucose levels on the short term mortality in patients with acute ST-segment elevation myocardial infarction].

Abstract

OBJECTIVE:

To evaluate the predictive value of different admission blood glucose levels for short-term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI).

METHOD:

An observational analysis of 7446 Chinese STEMI patients from a global randomized controlled trials were recruited within 12 hours of symptom onset. According to the levels of admission glucose, these patients were divided into six groups, admission glucose < 4.50 mmol/L was defined as the hypoglycemia group; glucose of 4.5 - 5.5 mmol/L a control; 5.6 - 7.0 mmol/L, 7.1 - 8.5 mmol/L (mild hyperglycemia group) and 8.6 - 11.0 mmol/L (moderate hyperglycemia group); glucose > 11.0 mmol/L was the severe hyperglycemia group. The 30-day mortality was analyzed.

RESULT:

Compared with the glucose of 4.5 - 5.5 mmol/L group, thirty-day mortality increased in patients with hypoglycemia (10.2%, P < 0.05), mild and moderate hyperglycemia (9.2%, P = 0.01; 11.6%, P < 0.01, respectively) and severe hyperglycemia (18.6%, P < 0.01). The highest mortality occurred in the severe hyperglycemia group. Multivariate logistic regression analysis showed that, as compared with glucose of 4.5 - 5.5 mmol/L, the mild and the moderate hyperglycemia groups had a mortality increasing of 46% (OR 1.46, 95% CI 1.03 - 2.07, P = 0.01) and 58% fold (OR 1.58, 95% CI 1.13 - 2.22 P = 0.02) respectively; the severe hyperglycemia group had a risk of death of 2.26 folds (OR 2.26, 95% CI 1.62 - 3.14, P = 0.05). Mild, moderate and severe hyperglycemia were independent predictors of 30-day mortality.

CONCLUSION:

The 30-day mortality was higher in STEMI patients with mild, moderate and severe hyperglycemia at admission. Admission blood glucose level is an important factor associated with a short-term.

• Authors: Yan-Min Yang, Yao Liu, Jun Zhu, Hui-Qiong Tan, Yan Liang, Ying Li, Jian-Dong Li, Yan Zhang, Li-Sheng Liu
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 89 Issue 18 Pg. 1230-3 (May 12 2009) ISSN: 0376-2491 [Print] China
• PMID: 19595174 (Publication Type: English Abstract, Journal Article)

Chemical References

• Blood Glucose

Topics

• Aged
• Blood Glucose (analysis)
• Electrocardiography
• Female
• Humans
• Hyperglycemia (complications)
• Hypoglycemia (complications)
• Inpatients
• Middle Aged
• Myocardial Infarction (blood, mortality, physiopathology)
• Predictive Value of Tests
• Prognosis
• Randomized Controlled Trials as Topic
• Survival Rate