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Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention.
Kardiol Pol 2010; 68(7):743-51KP

Abstract

BACKGROUND

It has been shown that hyperglycaemia is associated with increased in-hospital and long-term mortality in patients with myocardial infarction (MI). There are only a few reports on the relationship between glycaemia in the acute phase of MI complicated by cardiogenic shock (CS) and prognosis.

AIM

To assess the relationship between blood glucose level on admission and in-hospital as well as long-term mortality in patients with acute ST-segment elevation MI (STEMI) complicated by CS treated with percutaneous coronary intervention (PCI).

METHODS

Consecutive patients with STEMI complicated by CS treated with PCI were included. For the purpose of this analysis, the patients were divided into two groups: the first group included patients with glycaemia on admission < 7.8 mmol/L, and the other group patients with glycaemia > or = 7.8 mmol/L (hyperglycaemia group). Selected parameters from the in-hospital and long-term follow-up were compared between the two groups. Due to a possible linear relationship between blood glucose and mortality in multivariate analysis, glucose level on admission was treated as a continuous variable. The primary outcomes included in-hospital, 1-year and 5-year mortality.

RESULTS

Out of 3166 consecutive patients with STEMI, 258 had CS and available data on glycaemia. In patients with hyperglycaemia on admission, we observed higher in-hospital (41.5% vs 28%, p = 0.041), 1-year (51.4% vs 34.7%, p = 0.015) and 5-year (65.8% vs 43.3%, p = 0.034) mortality in comparison to the patients with blood glucose < 7.8 mmol/L. The multivariate analysis revealed that blood glucose level on admission (per each glycaemia increment by 1 mmol/L) was an independent prognostic factor of in-hospital (OR 1.08, 95% CI 1.02-1.14, p = 0.0044), 1-year (HR 1.04, 95% CI 1.01-1.06, p = 0.005) and 5-year mortality (HR 1.03, 95% CI 1.01-1.05, p = 0.045). Of note, the diagnosis of diabetes mellitus had no influence on in-hospital and long-term mortality.

CONCLUSIONS

Elevated blood glucose level on admission, regardless of the diagnosis of diabetes mellitus, results in increased in-hospital and long-term mortality in patients with STEMI complicated by CS and treated with PCI.

Authors+Show Affiliations

Department of Cardiology, Silesian Medical University, Zabrze, Poland. damianpres@wp.plNo 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

Language

eng

PubMed ID

20648428

Citation

Pres, Damian, et al. "Blood Glucose Level On Admission Determines In-hospital and Long-term Mortality in Patients With ST-segment Elevation Myocardial Infarction Complicated By Cardiogenic Shock Treated With Percutaneous Coronary Intervention." Kardiologia Polska, vol. 68, no. 7, 2010, pp. 743-51.
Pres D, Gasior M, Strojek K, et al. Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention. Kardiol Pol. 2010;68(7):743-51.
Pres, D., Gasior, M., Strojek, K., Gierlotka, M., Hawranek, M., Lekston, A., ... Poloński, L. (2010). Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention. Kardiologia Polska, 68(7), pp. 743-51.
Pres D, et al. Blood Glucose Level On Admission Determines In-hospital and Long-term Mortality in Patients With ST-segment Elevation Myocardial Infarction Complicated By Cardiogenic Shock Treated With Percutaneous Coronary Intervention. Kardiol Pol. 2010;68(7):743-51. PubMed PMID: 20648428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention. AU - Pres,Damian, AU - Gasior,Mariusz, AU - Strojek,Krzysztof, AU - Gierlotka,Marek, AU - Hawranek,Michał, AU - Lekston,Andrzej, AU - Wilczek,Krzysztof, AU - Tajstra,Mateusz, AU - Gumprecht,Janusz, AU - Poloński,Lech, PY - 2010/7/22/entrez PY - 2010/7/22/pubmed PY - 2010/11/16/medline SP - 743 EP - 51 JF - Kardiologia polska JO - Kardiol Pol VL - 68 IS - 7 N2 - BACKGROUND: It has been shown that hyperglycaemia is associated with increased in-hospital and long-term mortality in patients with myocardial infarction (MI). There are only a few reports on the relationship between glycaemia in the acute phase of MI complicated by cardiogenic shock (CS) and prognosis. AIM: To assess the relationship between blood glucose level on admission and in-hospital as well as long-term mortality in patients with acute ST-segment elevation MI (STEMI) complicated by CS treated with percutaneous coronary intervention (PCI). METHODS: Consecutive patients with STEMI complicated by CS treated with PCI were included. For the purpose of this analysis, the patients were divided into two groups: the first group included patients with glycaemia on admission < 7.8 mmol/L, and the other group patients with glycaemia > or = 7.8 mmol/L (hyperglycaemia group). Selected parameters from the in-hospital and long-term follow-up were compared between the two groups. Due to a possible linear relationship between blood glucose and mortality in multivariate analysis, glucose level on admission was treated as a continuous variable. The primary outcomes included in-hospital, 1-year and 5-year mortality. RESULTS: Out of 3166 consecutive patients with STEMI, 258 had CS and available data on glycaemia. In patients with hyperglycaemia on admission, we observed higher in-hospital (41.5% vs 28%, p = 0.041), 1-year (51.4% vs 34.7%, p = 0.015) and 5-year (65.8% vs 43.3%, p = 0.034) mortality in comparison to the patients with blood glucose < 7.8 mmol/L. The multivariate analysis revealed that blood glucose level on admission (per each glycaemia increment by 1 mmol/L) was an independent prognostic factor of in-hospital (OR 1.08, 95% CI 1.02-1.14, p = 0.0044), 1-year (HR 1.04, 95% CI 1.01-1.06, p = 0.005) and 5-year mortality (HR 1.03, 95% CI 1.01-1.05, p = 0.045). Of note, the diagnosis of diabetes mellitus had no influence on in-hospital and long-term mortality. CONCLUSIONS: Elevated blood glucose level on admission, regardless of the diagnosis of diabetes mellitus, results in increased in-hospital and long-term mortality in patients with STEMI complicated by CS and treated with PCI. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/20648428/Blood_glucose_level_on_admission_determines_in_hospital_and_long_term_mortality_in_patients_with_ST_segment_elevation_myocardial_infarction_complicated_by_cardiogenic_shock_treated_with_percutaneous_coronary_intervention_ L2 - https://medlineplus.gov/hyperglycemia.html DB - PRIME DP - Unbound Medicine ER -