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Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics.
Eur J Cardiovasc Prev Rehabil 2010; 17(2):155-9EJ

Abstract

OBJECTIVE

To evaluate the impact of admission glycaemia on short-term and long-term prognosis in diabetic and non-diabetic patients admitted for acute coronary syndromes (ACS), and to identify the independent predictors of post-ACS mortality in this population.

METHODS

This study included 1149 consecutive patients admitted to a single coronary care unit for ACS between May 2004 and December 2006. Our population was divided into four groups according to the quartiles of glycaemia at admission [Q1 <5.77 mmol/l, Q2 (5.77-7.0) mmol/l, Q3 (7.0-9.22) mmol/l and Q4 > or =9.22 mmol/l]. Diabetic (n = 396) and non-diabetic (n = 753) subgroups were then separately analysed.

RESULTS

Hyperglycaemia at admission was associated with worse cardiovascular risk profile, high levels of necrosis and inflammation biomarkers and low left ventricle ejection fraction. Considering overall population, in-hospital, 30-day and 3-year mortalities were higher in more elevated glycaemia quartiles. In diabetic patients, there were no significant differences in mortality among glycaemia quartiles; however, in non-diabetic group higher admission glucose levels were associated with successively higher in-hospital and 3-year mortalities. After multivariate regression analysis, glycaemia at admission > or =5.77 mmol/l, age > or =72 years, Killip class >1 and troponin I > or =6.0 ng/ml were independent predictors of in-hospital mortality.

CONCLUSION

This study suggests that, in a broad ACS population, hyperglycaemia at admission is a short-term and long-term bad prognosis marker, particularly in non-diabetic patients, being a strong independent predictor of in-hospital mortality.

Authors+Show Affiliations

Cardiology Department, Coimbra University Hospital, Coimbra, Portugal. silvia.reis.monteiro@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20110816

Citation

Monteiro, Sílvia, et al. "Hyperglycaemia at Admission in Acute Coronary Syndrome Patients: Prognostic Value in Diabetics and Non-diabetics." European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, vol. 17, no. 2, 2010, pp. 155-9.
Monteiro S, Monteiro P, Gonçalves F, et al. Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. Eur J Cardiovasc Prev Rehabil. 2010;17(2):155-9.
Monteiro, S., Monteiro, P., Gonçalves, F., Freitas, M., & Providência, L. A. (2010). Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 17(2), pp. 155-9. doi:10.1097/HJR.0b013e32832e19a3.
Monteiro S, et al. Hyperglycaemia at Admission in Acute Coronary Syndrome Patients: Prognostic Value in Diabetics and Non-diabetics. Eur J Cardiovasc Prev Rehabil. 2010;17(2):155-9. PubMed PMID: 20110816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. AU - Monteiro,Sílvia, AU - Monteiro,Pedro, AU - Gonçalves,Francisco, AU - Freitas,Mário, AU - Providência,Luís A, PY - 2010/1/30/entrez PY - 2010/1/30/pubmed PY - 2010/7/10/medline SP - 155 EP - 9 JF - European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology JO - Eur J Cardiovasc Prev Rehabil VL - 17 IS - 2 N2 - OBJECTIVE: To evaluate the impact of admission glycaemia on short-term and long-term prognosis in diabetic and non-diabetic patients admitted for acute coronary syndromes (ACS), and to identify the independent predictors of post-ACS mortality in this population. METHODS: This study included 1149 consecutive patients admitted to a single coronary care unit for ACS between May 2004 and December 2006. Our population was divided into four groups according to the quartiles of glycaemia at admission [Q1 <5.77 mmol/l, Q2 (5.77-7.0) mmol/l, Q3 (7.0-9.22) mmol/l and Q4 > or =9.22 mmol/l]. Diabetic (n = 396) and non-diabetic (n = 753) subgroups were then separately analysed. RESULTS: Hyperglycaemia at admission was associated with worse cardiovascular risk profile, high levels of necrosis and inflammation biomarkers and low left ventricle ejection fraction. Considering overall population, in-hospital, 30-day and 3-year mortalities were higher in more elevated glycaemia quartiles. In diabetic patients, there were no significant differences in mortality among glycaemia quartiles; however, in non-diabetic group higher admission glucose levels were associated with successively higher in-hospital and 3-year mortalities. After multivariate regression analysis, glycaemia at admission > or =5.77 mmol/l, age > or =72 years, Killip class >1 and troponin I > or =6.0 ng/ml were independent predictors of in-hospital mortality. CONCLUSION: This study suggests that, in a broad ACS population, hyperglycaemia at admission is a short-term and long-term bad prognosis marker, particularly in non-diabetic patients, being a strong independent predictor of in-hospital mortality. SN - 1741-8275 UR - https://www.unboundmedicine.com/medline/citation/20110816/Hyperglycaemia_at_admission_in_acute_coronary_syndrome_patients:_prognostic_value_in_diabetics_and_non_diabetics_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=20110816.ui DB - PRIME DP - Unbound Medicine ER -