Tags

Type your tag names separated by a space and hit enter

Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients.
Int J Cardiol. 2017 Jun 01; 236:9-15.IJ

Abstract

BACKGROUND

Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.

METHODS

A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.

RESULTS

In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA1C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, p<0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, p<0.001). Comorbidity including cardiogenic shock (p<0.001), cerebral hemorrhage (p=0.012), decreased Hb≥5g/dL (p=0.013), atrioventricular block (p<0.001) and ventricular tachycardia (p=0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.

CONCLUSIONS

These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.

Authors+Show Affiliations

Chonnam National University Hospital, Gwangju, Republic of Korea.Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address: myungho@chollian.net.Chonnam National University Hospital, Gwangju, Republic of Korea.Gachon University Gil Medical Center, Incheon, Republic of Korea.The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Republic of Korea.Korea University Guro Hospital, Seoul, Republic of Korea.Seoul National University Hospital, Seoul, Republic of Korea.Sungkyunkwan Universtiy Samsung Medical Center, Seoul, Republic of Korea.Chungnam National University Hospital, Daejeon, Republic of Korea.Chungbuk National University Hospital, Cheongju, Republic of Korea.Kyungpook National University Hospital, Daegu, Republic of Korea.Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.Yeungnam University Hospital, Daegu, Republic of Korea.Pusan National University Hospital, Busan, Republic of Korea.Wonkwang University Hospital, Iksan, Republic of Korea.Chonbuk National University Hospital, Jeonju, Republic of Korea.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28126258

Citation

Kim, Eun Jung, et al. "Clinical Impact of Admission Hyperglycemia On In-hospital Mortality in Acute Myocardial Infarction Patients." International Journal of Cardiology, vol. 236, 2017, pp. 9-15.
Kim EJ, Jeong MH, Kim JH, et al. Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients. Int J Cardiol. 2017;236:9-15.
Kim, E. J., Jeong, M. H., Kim, J. H., Ahn, T. H., Seung, K. B., Oh, D. J., Kim, H. S., Gwon, H. C., Seong, I. W., Hwang, K. K., Chae, S. C., Kim, K. B., Kim, Y. J., Cha, K. S., Oh, S. K., & Chae, J. K. (2017). Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients. International Journal of Cardiology, 236, 9-15. https://doi.org/10.1016/j.ijcard.2017.01.095
Kim EJ, et al. Clinical Impact of Admission Hyperglycemia On In-hospital Mortality in Acute Myocardial Infarction Patients. Int J Cardiol. 2017 Jun 1;236:9-15. PubMed PMID: 28126258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients. AU - Kim,Eun Jung, AU - Jeong,Myung Ho, AU - Kim,Ju Han, AU - Ahn,Tae Hoon, AU - Seung,Ki Bae, AU - Oh,Dong Joo, AU - Kim,Hyo-Soo, AU - Gwon,Hyeon Cheol, AU - Seong,In Whan, AU - Hwang,Kyung Kuk, AU - Chae,Shung Chull, AU - Kim,Kwon-Bae, AU - Kim,Young Jo, AU - Cha,Kwang Soo, AU - Oh,Seok Kyu, AU - Chae,Jei Keon, AU - ,, Y1 - 2017/01/19/ PY - 2016/10/10/received PY - 2016/12/12/revised PY - 2017/01/13/accepted PY - 2017/1/28/pubmed PY - 2017/12/9/medline PY - 2017/1/28/entrez KW - Diabetes mellitus KW - Hyperglycemia KW - Myocardial infarction SP - 9 EP - 15 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 236 N2 - BACKGROUND: Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate. METHODS: A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status. RESULTS: In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA1C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, p<0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, p<0.001). Comorbidity including cardiogenic shock (p<0.001), cerebral hemorrhage (p=0.012), decreased Hb≥5g/dL (p=0.013), atrioventricular block (p<0.001) and ventricular tachycardia (p=0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients. CONCLUSIONS: These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/28126258/Clinical_impact_of_admission_hyperglycemia_on_in_hospital_mortality_in_acute_myocardial_infarction_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(16)32921-7 DB - PRIME DP - Unbound Medicine ER -