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Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients.
Diabetes Care. 2014 Aug; 37(8):2366-73.DC

Abstract

OBJECTIVE

We aimed to evaluate the association between hypoglycemia at admission and 30-day mortality in patients with acute myocardial infarction (AMI) and to determine whether these associations differed according to diabetes-control status in AMI patients with diabetes.

RESEARCH DESIGN AND METHODS

We analyzed the prognostic significance of hypoglycemia and hyperglycemia in 34,943 AMI patients with or without type 2 diabetes from two AMI registries: the Korea Acute Myocardial Infarction Registry (KAMIR) and the Korea Working Group on Myocardial Infarction (KorMI).

RESULTS

The patients were divided into five groups according to serum-glucose levels at admission: <3.9 mmol/L (<70 mg/dL); 3.9-7.72 mmol/L (70-139 mg/dL); 7.78-11.06 mmol/L (140-199 mg/dL); 11.11-14.39 mmol/L (200-259 mg/dL); and ≥14.44 mmol/L (≥260 mg/dL). The 30-day mortality rates in the lowest and highest glucose groups were higher than those in other groups; the lowest glucose group had the highest mortality for patients with type 2 diabetes, after adjusting for multiple factors. We also extracted and compared four subgroups from the patients with type 2 diabetes, based on hemoglobin A1c and serum-glucose levels at admission: group A, <6.5% (48 mmol/mol) and <3.9 mmol/L; group B, <6.5% (48 mmol/mol) and ≥11.11 mmol/L; group C, ≥8% (64 mmol/mol) and <3.9 mmol/L; and group D, ≥8% (64 mmol/mol) and ≥11.11 mmol/L. Group C had the highest 30-day mortality rate among the groups.

CONCLUSIONS

These data suggest that hypoglycemia at admission affects clinical outcomes differently in AMI patients with type 2 diabetes depending on the diabetes-control status.

Authors+Show Affiliations

Department of Internal Medicine, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Republic of Korea.Department of Anesthesiology, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Republic of Korea.Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea drhormone@naver.com myungho@chollian.net.Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.Department of Internal Medicine, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Republic of Korea.Department of Public Health, Wonkwang University, Iksan, Republic of Korea.Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea.Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea.Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea.Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea.Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea drhormone@naver.com myungho@chollian.net.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24914243

Citation

Lee, Sang Ah, et al. "Hypoglycemia at Admission in Patients With Acute Myocardial Infarction Predicts a Higher 30-day Mortality in Patients With Poorly Controlled Type 2 Diabetes Than in Well-controlled Patients." Diabetes Care, vol. 37, no. 8, 2014, pp. 2366-73.
Lee SA, Cho SJ, Jeong MH, et al. Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients. Diabetes Care. 2014;37(8):2366-73.
Lee, S. A., Cho, S. J., Jeong, M. H., Kim, Y. J., Kim, C. J., Cho, M. C., Kim, H. S., Ahn, Y., Koh, G., Lee, J. M., Oh, S. K., Yun, K. H., Kim, H. Y., Cho, C. G., & Lee, D. H. (2014). Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients. Diabetes Care, 37(8), 2366-73. https://doi.org/10.2337/dc13-2856
Lee SA, et al. Hypoglycemia at Admission in Patients With Acute Myocardial Infarction Predicts a Higher 30-day Mortality in Patients With Poorly Controlled Type 2 Diabetes Than in Well-controlled Patients. Diabetes Care. 2014;37(8):2366-73. PubMed PMID: 24914243.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients. AU - Lee,Sang Ah, AU - Cho,Suk Ju, AU - Jeong,Myung Ho, AU - Kim,Young Jo, AU - Kim,Chong Jin, AU - Cho,Myeong Chan, AU - Kim,Hyo-Soo, AU - Ahn,Youngkeun, AU - Koh,Gwanpyo, AU - Lee,Jeong Mi, AU - Oh,Seok Kyu, AU - Yun,Kyeong Ho, AU - Kim,Ha Young, AU - Cho,Chung Gu, AU - Lee,Dae Ho, AU - ,, Y1 - 2014/06/09/ PY - 2014/6/11/entrez PY - 2014/6/11/pubmed PY - 2015/10/2/medline SP - 2366 EP - 73 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 8 N2 - OBJECTIVE: We aimed to evaluate the association between hypoglycemia at admission and 30-day mortality in patients with acute myocardial infarction (AMI) and to determine whether these associations differed according to diabetes-control status in AMI patients with diabetes. RESEARCH DESIGN AND METHODS: We analyzed the prognostic significance of hypoglycemia and hyperglycemia in 34,943 AMI patients with or without type 2 diabetes from two AMI registries: the Korea Acute Myocardial Infarction Registry (KAMIR) and the Korea Working Group on Myocardial Infarction (KorMI). RESULTS: The patients were divided into five groups according to serum-glucose levels at admission: <3.9 mmol/L (<70 mg/dL); 3.9-7.72 mmol/L (70-139 mg/dL); 7.78-11.06 mmol/L (140-199 mg/dL); 11.11-14.39 mmol/L (200-259 mg/dL); and ≥14.44 mmol/L (≥260 mg/dL). The 30-day mortality rates in the lowest and highest glucose groups were higher than those in other groups; the lowest glucose group had the highest mortality for patients with type 2 diabetes, after adjusting for multiple factors. We also extracted and compared four subgroups from the patients with type 2 diabetes, based on hemoglobin A1c and serum-glucose levels at admission: group A, <6.5% (48 mmol/mol) and <3.9 mmol/L; group B, <6.5% (48 mmol/mol) and ≥11.11 mmol/L; group C, ≥8% (64 mmol/mol) and <3.9 mmol/L; and group D, ≥8% (64 mmol/mol) and ≥11.11 mmol/L. Group C had the highest 30-day mortality rate among the groups. CONCLUSIONS: These data suggest that hypoglycemia at admission affects clinical outcomes differently in AMI patients with type 2 diabetes depending on the diabetes-control status. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24914243/Hypoglycemia_at_admission_in_patients_with_acute_myocardial_infarction_predicts_a_higher_30_day_mortality_in_patients_with_poorly_controlled_type_2_diabetes_than_in_well_controlled_patients_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=24914243 DB - PRIME DP - Unbound Medicine ER -