Tags

Type your tag names separated by a space and hit enter

High admission glucose levels predict worse short-term clinical outcome in non-diabetic patients with acute myocardial infraction: a retrospective observational study.
BMC Cardiovasc Disord. 2019 07 04; 19(1):163.BC

Abstract

BACKGROUND

Patients with acute myocardial infarction (AMI) often accompanied by admission hyperglycemia, which usually predicts a poor clinical outcomes for non-diabetes mellitus. Appropriate cut-point to identify high risk individuals in these patients remains controversial.

METHODS

One thousand six hundred ninety-eight non-diabetes AMI patients in this retrospective study were divided into 3 groups according to admission glucose levels (euglycemia group≤140 mg/dL, moderate hyperglycemia group 141-179 mg/dL, severe hyperglycemia group≥180 mg/dL). The primary endpoint of this study was all-cause in-hospital mortality rate. In-hospital motality related risk factors was analyzed by multivariate binary logistic regression analyses.

RESULTS

All myocardial necrosis markers and Log NT-proBNP in severe hyperglycemia group were significantly higher than those in the other 2 groups. Logistic regression showed that independent predictors of the in-hospital mortality rate in non-diabetic patients with AMI were age (OR = 1.057, 95% CI 1.024-1.091, P < 0.001), logarithm of the N-terminal pro-brain natriuretic peptide (OR = 7.697, 95% CI 3.810-15.550, P < 0.001), insufficient myocardial reperfusion (OR = 7.654, 95% CI 2.109-27.779, P < 0.001), percutaneous coronary intervention (OR = 0.221, 95% CI 0.108-0.452, P < 0.001) and admission glucose (as categorical variable). Patients with moderate hyperglycemia (OR = 1.186, 95% CI 0.585-2.408, P = .636) and severe hyperglycemia (OR = 4.595, 95% CI 1.942-10.873, P = 0.001) had a higher all-cause in-hospital mortality rate compared with those with euglycemia after AMI in non-diabetic patients.

CONCLUSIONS

The all-cause in-hospital mortality risk increases remarkably as admission glucose levels elevated in non-diabetic patients with AMI, especially in patients with admission glucose levels ≥180 mg/dL. Severe admission hyperglycemia could be regarded as prospective high-risk marker for non-diabetic AMI patients.

Authors+Show Affiliations

Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, People's Republic of China.National Clinical Research Center of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, People's Republic of China.Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, People's Republic of China.Clinical Atherosclerosis Research Lab, Division of Cardiology, University of Washington, 1959 NE Pacific Street, Seattle, WA, USA.Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, People's Republic of China. lhw19656@sina.com. Department of Internal Medicine, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, People's Republic of China. lhw19656@sina.com. Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, 100069, People's Republic of China. lhw19656@sina.com.

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31272376

Citation

Ding, Xiao Song, et al. "High Admission Glucose Levels Predict Worse Short-term Clinical Outcome in Non-diabetic Patients With Acute Myocardial Infraction: a Retrospective Observational Study." BMC Cardiovascular Disorders, vol. 19, no. 1, 2019, p. 163.
Ding XS, Wu SS, Chen H, et al. High admission glucose levels predict worse short-term clinical outcome in non-diabetic patients with acute myocardial infraction: a retrospective observational study. BMC Cardiovasc Disord. 2019;19(1):163.
Ding, X. S., Wu, S. S., Chen, H., Zhao, X. Q., & Li, H. W. (2019). High admission glucose levels predict worse short-term clinical outcome in non-diabetic patients with acute myocardial infraction: a retrospective observational study. BMC Cardiovascular Disorders, 19(1), 163. https://doi.org/10.1186/s12872-019-1140-1
Ding XS, et al. High Admission Glucose Levels Predict Worse Short-term Clinical Outcome in Non-diabetic Patients With Acute Myocardial Infraction: a Retrospective Observational Study. BMC Cardiovasc Disord. 2019 07 4;19(1):163. PubMed PMID: 31272376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High admission glucose levels predict worse short-term clinical outcome in non-diabetic patients with acute myocardial infraction: a retrospective observational study. AU - Ding,Xiao Song, AU - Wu,Shan Shan, AU - Chen,Hui, AU - Zhao,Xue Qiao, AU - Li,Hong Wei, Y1 - 2019/07/04/ PY - 2019/03/13/received PY - 2019/06/24/accepted PY - 2019/7/6/entrez PY - 2019/7/6/pubmed PY - 2020/5/19/medline KW - Acute myocardial infarction KW - Admission hyperglycemia KW - In-hospital mortality KW - Non-diabetes mellitus SP - 163 EP - 163 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 19 IS - 1 N2 - BACKGROUND: Patients with acute myocardial infarction (AMI) often accompanied by admission hyperglycemia, which usually predicts a poor clinical outcomes for non-diabetes mellitus. Appropriate cut-point to identify high risk individuals in these patients remains controversial. METHODS: One thousand six hundred ninety-eight non-diabetes AMI patients in this retrospective study were divided into 3 groups according to admission glucose levels (euglycemia group≤140 mg/dL, moderate hyperglycemia group 141-179 mg/dL, severe hyperglycemia group≥180 mg/dL). The primary endpoint of this study was all-cause in-hospital mortality rate. In-hospital motality related risk factors was analyzed by multivariate binary logistic regression analyses. RESULTS: All myocardial necrosis markers and Log NT-proBNP in severe hyperglycemia group were significantly higher than those in the other 2 groups. Logistic regression showed that independent predictors of the in-hospital mortality rate in non-diabetic patients with AMI were age (OR = 1.057, 95% CI 1.024-1.091, P < 0.001), logarithm of the N-terminal pro-brain natriuretic peptide (OR = 7.697, 95% CI 3.810-15.550, P < 0.001), insufficient myocardial reperfusion (OR = 7.654, 95% CI 2.109-27.779, P < 0.001), percutaneous coronary intervention (OR = 0.221, 95% CI 0.108-0.452, P < 0.001) and admission glucose (as categorical variable). Patients with moderate hyperglycemia (OR = 1.186, 95% CI 0.585-2.408, P = .636) and severe hyperglycemia (OR = 4.595, 95% CI 1.942-10.873, P = 0.001) had a higher all-cause in-hospital mortality rate compared with those with euglycemia after AMI in non-diabetic patients. CONCLUSIONS: The all-cause in-hospital mortality risk increases remarkably as admission glucose levels elevated in non-diabetic patients with AMI, especially in patients with admission glucose levels ≥180 mg/dL. Severe admission hyperglycemia could be regarded as prospective high-risk marker for non-diabetic AMI patients. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/31272376/High_admission_glucose_levels_predict_worse_short_term_clinical_outcome_in_non_diabetic_patients_with_acute_myocardial_infraction:_a_retrospective_observational_study_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-019-1140-1 DB - PRIME DP - Unbound Medicine ER -