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Fasting glucose in acute myocardial infarction: incremental value for long-term mortality and relationship with left ventricular systolic function.
Diabetes Care. 2007 Apr; 30(4):960-6.DC

Abstract

OBJECTIVE

Elevation of blood glucose is a common metabolic disorder among patients with acute myocardial infarction (AMI) and is associated with adverse prognosis. However, few data are available concerning the long-term prognostic value of elevated fasting glucose during the acute phase of infarction.

RESEARCH DESIGN AND METHODS

We prospectively studied the relationship between fasting glucose and long-term mortality in patients with AMI. Fasting glucose was determined after an >/=8 h fast within 24 h of admission. The median duration of follow-up was 24 months (range 6-48). All multivariable Cox models were adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score.

RESULTS

In nondiabetic patients (n = 1,101), compared with patients with normal fasting glucose (<100 mg/dl), the adjusted hazard ratio for mortality progressively increased with higher tertiles of elevated fasting glucose (first tertile 1.5 [95% CI 0.8-2.9], P = 0.19; second tertile 3.2 [1.9-5.5], P < 0.0001; third tertile 5.7 [3.5-9.3], P < 0.0001). The c statistic of the model containing the GRACE risk score increased when fasting glucose data were added (0.8 +/- 0.02-0.85 +/- 0.02, P = 0.004). Fasting glucose remained an independent predictor of mortality after further adjustment for ejection fraction. Elevated fasting glucose did not predict mortality in patients with diabetes (n = 462).

CONCLUSIONS

Fasting glucose is a simple robust tool for predicting long-term mortality in nondiabetic patients with AMI. Fasting glucose provides incremental prognostic information when added to the GRACE risk score and left ventricular ejection fraction. Fasting glucose is not a useful prognostic marker in patients with diabetes.

Authors+Show Affiliations

Department of Cardiology, Rambam Medical Center, Haifa, Israel. daronson@tx.technion.ac.ilNo 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

17392556

Citation

Aronson, Doron, et al. "Fasting Glucose in Acute Myocardial Infarction: Incremental Value for Long-term Mortality and Relationship With Left Ventricular Systolic Function." Diabetes Care, vol. 30, no. 4, 2007, pp. 960-6.
Aronson D, Hammerman H, Kapeliovich MR, et al. Fasting glucose in acute myocardial infarction: incremental value for long-term mortality and relationship with left ventricular systolic function. Diabetes Care. 2007;30(4):960-6.
Aronson, D., Hammerman, H., Kapeliovich, M. R., Suleiman, A., Agmon, Y., Beyar, R., Markiewicz, W., & Suleiman, M. (2007). Fasting glucose in acute myocardial infarction: incremental value for long-term mortality and relationship with left ventricular systolic function. Diabetes Care, 30(4), 960-6.
Aronson D, et al. Fasting Glucose in Acute Myocardial Infarction: Incremental Value for Long-term Mortality and Relationship With Left Ventricular Systolic Function. Diabetes Care. 2007;30(4):960-6. PubMed PMID: 17392556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fasting glucose in acute myocardial infarction: incremental value for long-term mortality and relationship with left ventricular systolic function. AU - Aronson,Doron, AU - Hammerman,Haim, AU - Kapeliovich,Michael R, AU - Suleiman,Abeer, AU - Agmon,Yoram, AU - Beyar,Rafael, AU - Markiewicz,Walter, AU - Suleiman,Mahmoud, PY - 2007/3/30/pubmed PY - 2007/6/15/medline PY - 2007/3/30/entrez SP - 960 EP - 6 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 4 N2 - OBJECTIVE: Elevation of blood glucose is a common metabolic disorder among patients with acute myocardial infarction (AMI) and is associated with adverse prognosis. However, few data are available concerning the long-term prognostic value of elevated fasting glucose during the acute phase of infarction. RESEARCH DESIGN AND METHODS: We prospectively studied the relationship between fasting glucose and long-term mortality in patients with AMI. Fasting glucose was determined after an >/=8 h fast within 24 h of admission. The median duration of follow-up was 24 months (range 6-48). All multivariable Cox models were adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score. RESULTS: In nondiabetic patients (n = 1,101), compared with patients with normal fasting glucose (<100 mg/dl), the adjusted hazard ratio for mortality progressively increased with higher tertiles of elevated fasting glucose (first tertile 1.5 [95% CI 0.8-2.9], P = 0.19; second tertile 3.2 [1.9-5.5], P < 0.0001; third tertile 5.7 [3.5-9.3], P < 0.0001). The c statistic of the model containing the GRACE risk score increased when fasting glucose data were added (0.8 +/- 0.02-0.85 +/- 0.02, P = 0.004). Fasting glucose remained an independent predictor of mortality after further adjustment for ejection fraction. Elevated fasting glucose did not predict mortality in patients with diabetes (n = 462). CONCLUSIONS: Fasting glucose is a simple robust tool for predicting long-term mortality in nondiabetic patients with AMI. Fasting glucose provides incremental prognostic information when added to the GRACE risk score and left ventricular ejection fraction. Fasting glucose is not a useful prognostic marker in patients with diabetes. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/17392556/Fasting_glucose_in_acute_myocardial_infarction:_incremental_value_for_long_term_mortality_and_relationship_with_left_ventricular_systolic_function_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=17392556 DB - PRIME DP - Unbound Medicine ER -