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Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention.
Am Heart J. 2005 Nov; 150(5):1000-6.AH

Abstract

BACKGROUND

In patients with acute myocardial infarction (MI), increased plasma glucose levels at hospital admission are associated with worse outcome. We aimed to assess the predictive value of admission glucose concentrations on short- and long-term mortality in patients with acute MI undergoing primary or rescue percutaneous coronary intervention (PCI).

METHODS

We analyzed the 30-day and long-term (mean follow-up 3.7 years) outcome of 978 patients prospectively included in a single-center registry of patients with acute MI treated with PCI within 24 hours after onset of symptoms. Patients were classified according to plasma glucose levels at admission: < 7.8 mmol/L (group I, n = 322), 7.8 to 11 mmol/L (group II, n = 348), and > 11.0 mmol/L (group III, n = 308).

RESULTS

Mortality at 30 days was 1.2% in group I, 6.3% in group II, and 16.6% in group III (P < .001). After multivariate adjustment for age, the presence of cardiogenic shock, and TIMI 3 flow after PCI, the association of mortality with glucose classification remained significant (P value for trend = .003). The relative risk of death at 30 days for group III versus group I was 3.9 (95% CI 1.2-13.2). During long-term follow-up, mortality was similar in groups I and II. However, in group III adjusted mortality remained significantly increased compared with group I (relative risk 1.76, CI 1.01-3.08).

CONCLUSIONS

In patients undergoing emergency PCI for acute MI, glucose levels at hospital admission are predictive for short- and long-term survival. Knowledge of admission glucose levels may improve initial bedside risk stratification.

Authors+Show Affiliations

Division of Cardiology, Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland. edwin.straumann@triemli.stzh.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16290985

Citation

Straumann, Edwin, et al. "Admission Glucose Concentrations Independently Predict Early and Late Mortality in Patients With Acute Myocardial Infarction Treated By Primary or Rescue Percutaneous Coronary Intervention." American Heart Journal, vol. 150, no. 5, 2005, pp. 1000-6.
Straumann E, Kurz DJ, Muntwyler J, et al. Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention. Am Heart J. 2005;150(5):1000-6.
Straumann, E., Kurz, D. J., Muntwyler, J., Stettler, I., Furrer, M., Naegeli, B., Frielingsdorf, J., Schuiki, E., Mury, R., Bertel, O., & Spinas, G. A. (2005). Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention. American Heart Journal, 150(5), 1000-6.
Straumann E, et al. Admission Glucose Concentrations Independently Predict Early and Late Mortality in Patients With Acute Myocardial Infarction Treated By Primary or Rescue Percutaneous Coronary Intervention. Am Heart J. 2005;150(5):1000-6. PubMed PMID: 16290985.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention. AU - Straumann,Edwin, AU - Kurz,David J, AU - Muntwyler,Jörg, AU - Stettler,Irene, AU - Furrer,Marcel, AU - Naegeli,Barbara, AU - Frielingsdorf,Jürgen, AU - Schuiki,Ernst, AU - Mury,Raymond, AU - Bertel,Osmund, AU - Spinas,Giatgen A, PY - 2004/08/15/received PY - 2005/01/19/accepted PY - 2005/11/18/pubmed PY - 2005/12/31/medline PY - 2005/11/18/entrez SP - 1000 EP - 6 JF - American heart journal JO - Am. Heart J. VL - 150 IS - 5 N2 - BACKGROUND: In patients with acute myocardial infarction (MI), increased plasma glucose levels at hospital admission are associated with worse outcome. We aimed to assess the predictive value of admission glucose concentrations on short- and long-term mortality in patients with acute MI undergoing primary or rescue percutaneous coronary intervention (PCI). METHODS: We analyzed the 30-day and long-term (mean follow-up 3.7 years) outcome of 978 patients prospectively included in a single-center registry of patients with acute MI treated with PCI within 24 hours after onset of symptoms. Patients were classified according to plasma glucose levels at admission: < 7.8 mmol/L (group I, n = 322), 7.8 to 11 mmol/L (group II, n = 348), and > 11.0 mmol/L (group III, n = 308). RESULTS: Mortality at 30 days was 1.2% in group I, 6.3% in group II, and 16.6% in group III (P < .001). After multivariate adjustment for age, the presence of cardiogenic shock, and TIMI 3 flow after PCI, the association of mortality with glucose classification remained significant (P value for trend = .003). The relative risk of death at 30 days for group III versus group I was 3.9 (95% CI 1.2-13.2). During long-term follow-up, mortality was similar in groups I and II. However, in group III adjusted mortality remained significantly increased compared with group I (relative risk 1.76, CI 1.01-3.08). CONCLUSIONS: In patients undergoing emergency PCI for acute MI, glucose levels at hospital admission are predictive for short- and long-term survival. Knowledge of admission glucose levels may improve initial bedside risk stratification. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16290985/Admission_glucose_concentrations_independently_predict_early_and_late_mortality_in_patients_with_acute_myocardial_infarction_treated_by_primary_or_rescue_percutaneous_coronary_intervention_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00065-7 DB - PRIME DP - Unbound Medicine ER -