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[Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction patients with or without known diabetes].

Abstract

OBJECTIVE

To evaluate the impact of admission blood glucose level on 30-day mortality in ST-segment elevation acute myocardial infarction (STEMI) patients with or without known diabetes.

METHOD

This observational analysis enrolled 7446 Chinese STEMI patients hospitalized within 12 hours of symptom onset joining a global randomized controlled trial. The patients with or without known diabetes were divided into different groups by the admission blood glucose level: < 6.1 mmol/L (n = 2018), 6.1 to 7.7 mmol/L (n = 2170), 7.8 to 11.0 mmol/L (n = 1929), 11.1 to 13.0 mmol/L (n = 465), > 13.0 mmol/L (n = 864), the last three groups were defined as the hyperglycemia group. The 30-day mortality was analyzed.

RESULT

A substantial proportion of hyperglycemic patients did not have recognized diabetes. Insulin use during hospitalization in hyperglycemic patients without known diabetes was significantly lower than that in known diabetics with similar glucose levels. Incidence of 30-day mortality increased in proportion to increasing admission glucose levels in patients without known diabetes (glucose< 6.1 mmol/L 6.8%, 6.1 to 7.7 mmol/L 8.3%, glucose > 13.0 mmol/L 18.6%, P < 0.001). In patients with known diabetes, the 30-day mortality was 16.7% with admission glucose < 6.1 mmol/L and 8.2% with admission glucose 6.1 to 7.7 mmol/L, and 22.0% with admission glucose > 13.0 mmol/L (P < 0.001). Except in patients with admission glucose > 13.0 mmol/L, the 30-day mortality was significantly higher in patients without known diabetes than in patients with known diabetes at comparable admission glucose levels (all P < 0.05).

CONCLUSION

Comparing with the known diabetic patients, admission hyperglycemia is common in STEMI patients without known diabetes and was associated with higher 30-day mortality compared to known diabetes patients with comparable admission glucose level with the exception of admission glucose level > 13.0 mmol/L.

Authors+Show Affiliations

Department of Emergency, Chinese Academy of Medical Sciences, Beijing 100037, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

19961726

Citation

Liu, Yao, et al. "[Impact of Admission Blood Glucose On Prognosis of ST-segment Elevation Myocardial Infarction Patients With or Without Known Diabetes]." Zhonghua Xin Xue Guan Bing Za Zhi, vol. 37, no. 7, 2009, pp. 590-4.
Liu Y, Yang YM, Zhu J, et al. [Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction patients with or without known diabetes]. Zhonghua Xin Xue Guan Bing Za Zhi. 2009;37(7):590-4.
Liu, Y., Yang, Y. M., Zhu, J., Tan, H. Q., Liang, Y., Liu, L. S., & Li, Y. (2009). [Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction patients with or without known diabetes]. Zhonghua Xin Xue Guan Bing Za Zhi, 37(7), pp. 590-4.
Liu Y, et al. [Impact of Admission Blood Glucose On Prognosis of ST-segment Elevation Myocardial Infarction Patients With or Without Known Diabetes]. Zhonghua Xin Xue Guan Bing Za Zhi. 2009;37(7):590-4. PubMed PMID: 19961726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction patients with or without known diabetes]. AU - Liu,Yao, AU - Yang,Yan-min, AU - Zhu,Jun, AU - Tan,Hui-qiong, AU - Liang,Yan, AU - Liu,Li-sheng, AU - Li,Ying, PY - 2009/12/8/entrez PY - 2009/12/8/pubmed PY - 2010/5/12/medline SP - 590 EP - 4 JF - Zhonghua xin xue guan bing za zhi JO - Zhonghua Xin Xue Guan Bing Za Zhi VL - 37 IS - 7 N2 - OBJECTIVE: To evaluate the impact of admission blood glucose level on 30-day mortality in ST-segment elevation acute myocardial infarction (STEMI) patients with or without known diabetes. METHOD: This observational analysis enrolled 7446 Chinese STEMI patients hospitalized within 12 hours of symptom onset joining a global randomized controlled trial. The patients with or without known diabetes were divided into different groups by the admission blood glucose level: < 6.1 mmol/L (n = 2018), 6.1 to 7.7 mmol/L (n = 2170), 7.8 to 11.0 mmol/L (n = 1929), 11.1 to 13.0 mmol/L (n = 465), > 13.0 mmol/L (n = 864), the last three groups were defined as the hyperglycemia group. The 30-day mortality was analyzed. RESULT: A substantial proportion of hyperglycemic patients did not have recognized diabetes. Insulin use during hospitalization in hyperglycemic patients without known diabetes was significantly lower than that in known diabetics with similar glucose levels. Incidence of 30-day mortality increased in proportion to increasing admission glucose levels in patients without known diabetes (glucose< 6.1 mmol/L 6.8%, 6.1 to 7.7 mmol/L 8.3%, glucose > 13.0 mmol/L 18.6%, P < 0.001). In patients with known diabetes, the 30-day mortality was 16.7% with admission glucose < 6.1 mmol/L and 8.2% with admission glucose 6.1 to 7.7 mmol/L, and 22.0% with admission glucose > 13.0 mmol/L (P < 0.001). Except in patients with admission glucose > 13.0 mmol/L, the 30-day mortality was significantly higher in patients without known diabetes than in patients with known diabetes at comparable admission glucose levels (all P < 0.05). CONCLUSION: Comparing with the known diabetic patients, admission hyperglycemia is common in STEMI patients without known diabetes and was associated with higher 30-day mortality compared to known diabetes patients with comparable admission glucose level with the exception of admission glucose level > 13.0 mmol/L. SN - 0253-3758 UR - https://www.unboundmedicine.com/medline/citation/19961726/[Impact_of_admission_blood_glucose_on_prognosis_of_ST_segment_elevation_myocardial_infarction_patients_with_or_without_known_diabetes]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0253-3758&amp;year=2009&amp;vol=37&amp;issue=7&amp;fpage=590 DB - PRIME DP - Unbound Medicine ER -