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Admission glycaemia and outcome after acute coronary syndrome.
Int J Cardiol 2007; 116(3):315-20IJ

Abstract

BACKGROUND

Acute phase hyperglycaemia has been associated with increased mortality in patients with acute coronary syndrome. We investigated whether the predictive value of admission hyperglycaemia for mortality differs between diabetics and non-diabetics with acute coronary syndrome.

METHODS

Patients with acute coronary syndrome (n=1957) were followed up prospectively for 45 months. Patients were stratified into quartile groups defined by admission plasma glucose and hyperglycaemia was defined as plasma glucose of >9.4 mmol/l, which was the cut-off value for the 4th quartile. The relationship between admission hyperglycaemia and short-term (< or =30 day) and late (>30 day) mortality was analysed.

RESULTS

Of 1957 patients, 22% had a history of diabetes. Among patients without diabetes, those with hyperglycaemia had both a higher 30-day mortality rate (20.2% vs. 3.5%, p<0.0001) and late mortality rate (19.1% vs. 11.7%, p=0.007). Hyperglycaemic patients with diabetes had a higher late mortality rate than diabetic patients with plasma glucose of < or =9.4 mmol/l (29.3% vs. 14.9%, p=0.001). Of patients with hyperglycaemia at admission, those without diabetes had a higher 30-day mortality rate compared with those with diabetes (p=0.002).

CONCLUSION

Admission hyperglycaemia is a strong risk factor for mortality in patients with acute coronary syndrome and may be even stronger than a previous history of diabetes. Hyperglycaemic patients without recognised diabetes have a higher short-term mortality risk than hyperglycaemic patients with known diabetes.

Authors+Show Affiliations

Department of Cardiology, Sahlgrenska University Hospital, SE 413 45 Göteborg, Sweden. petur.petursson@vgregion.se <petur.petursson@vgregion.se>No 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

Language

eng

PubMed ID

16854479

Citation

Petursson, P, et al. "Admission Glycaemia and Outcome After Acute Coronary Syndrome." International Journal of Cardiology, vol. 116, no. 3, 2007, pp. 315-20.
Petursson P, Herlitz J, Caidahl K, et al. Admission glycaemia and outcome after acute coronary syndrome. Int J Cardiol. 2007;116(3):315-20.
Petursson, P., Herlitz, J., Caidahl, K., Gudbjörnsdottir, S., Karlsson, T., Perers, E., ... Hartford, M. (2007). Admission glycaemia and outcome after acute coronary syndrome. International Journal of Cardiology, 116(3), pp. 315-20.
Petursson P, et al. Admission Glycaemia and Outcome After Acute Coronary Syndrome. Int J Cardiol. 2007 Apr 4;116(3):315-20. PubMed PMID: 16854479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Admission glycaemia and outcome after acute coronary syndrome. AU - Petursson,P, AU - Herlitz,J, AU - Caidahl,K, AU - Gudbjörnsdottir,S, AU - Karlsson,T, AU - Perers,E, AU - Sjöland,H, AU - Hartford,M, Y1 - 2006/07/18/ PY - 2006/01/20/received PY - 2006/04/29/accepted PY - 2006/7/21/pubmed PY - 2007/3/3/medline PY - 2006/7/21/entrez SP - 315 EP - 20 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 116 IS - 3 N2 - BACKGROUND: Acute phase hyperglycaemia has been associated with increased mortality in patients with acute coronary syndrome. We investigated whether the predictive value of admission hyperglycaemia for mortality differs between diabetics and non-diabetics with acute coronary syndrome. METHODS: Patients with acute coronary syndrome (n=1957) were followed up prospectively for 45 months. Patients were stratified into quartile groups defined by admission plasma glucose and hyperglycaemia was defined as plasma glucose of >9.4 mmol/l, which was the cut-off value for the 4th quartile. The relationship between admission hyperglycaemia and short-term (< or =30 day) and late (>30 day) mortality was analysed. RESULTS: Of 1957 patients, 22% had a history of diabetes. Among patients without diabetes, those with hyperglycaemia had both a higher 30-day mortality rate (20.2% vs. 3.5%, p<0.0001) and late mortality rate (19.1% vs. 11.7%, p=0.007). Hyperglycaemic patients with diabetes had a higher late mortality rate than diabetic patients with plasma glucose of < or =9.4 mmol/l (29.3% vs. 14.9%, p=0.001). Of patients with hyperglycaemia at admission, those without diabetes had a higher 30-day mortality rate compared with those with diabetes (p=0.002). CONCLUSION: Admission hyperglycaemia is a strong risk factor for mortality in patients with acute coronary syndrome and may be even stronger than a previous history of diabetes. Hyperglycaemic patients without recognised diabetes have a higher short-term mortality risk than hyperglycaemic patients with known diabetes. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/16854479/Admission_glycaemia_and_outcome_after_acute_coronary_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(06)00466-9 DB - PRIME DP - Unbound Medicine ER -