TITLE

Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction

AUTHOR(S)
Van der Horst, Iwan C. C.; Nijsten, Maarten W. N.; Vogelzang, Mathijs; Zijlstra, Felix
PUB. DATE
January 2007
SOURCE
Cardiovascular Diabetology;2007, Vol. 6, p2
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Elevated blood glucose values are a prognostic factor in myocardial infarction (MI) patients. The unfavourable relation between hyperglycemia and outcome is known for admission glucose and fasting glucose after admission. These predictors are single measurements and thus not indicative of overall hyperglycemia. Increased persistent hyperglycemia may better predict adverse events in MI patients. Methods: In a prospective study of MI patients treated with primary percutaneous coronary intervention (PCI) frequent blood glucose measurements were obtained to investigate the relation between glucose and the occurrence of major adverse cardiac events (MACE) at 30 days follow-up. MACE was defined as death, recurrent infarction, repeat primary coronary intervention, and left ventricular ejection fraction equal to or smaller than 30%. Results: MACE occurred in 89 (21.3%) out 417 patients. In 17 patients (4.1%) it was a fatal event. A mean of 7.4 glucose determinations were available per patient. Mean +/- SD admission glucose was 10.1 +/- 3.7 mmol/L in patients with a MACE versus 9.1 +/- 2.7 mmol/L in event-free patients (P = 0.0024). Mean glucose during the first two days after admission was 9.0 +/- 2.8 mmol/L in patients with MACE compared to 8.1 +/- 2.0 mmol/L in event free patients (P < 0.0001). The area under the receiver operator characteristic curve was 0.64 for persistent hyperglycemia and 0.59 for admission glucose. Persistent hyperglycemia emerged as a significant independent predictor (P < 0.001). Conclusion: Persistent hyperglycemia in MI has a stronger relation with 30-day MACE than elevated glucose at admission.
ACCESSION #
28682830

 

Related Articles

  • In Patients With Acute Myocardial Infarction, the Impact of Hyperglycemia as a Risk Factor for Mortality Is Not Homogeneous Across Age-Groups. Nicolau, José Carlos; Serrano Jr., Carlos Vicente; Giraldez, Roberto Rocha; Baracioli, Luciano Moreira; Moreira, Humberto Graner; Lima, Felipe; Franken, Marcelo; Kalil, Roberto; Franchini Ramires, José Antonio; Giugliano, Robert P. // Diabetes Care;Jan2012, Vol. 35 Issue 1, p150 

    OBJECTIVE--To assess the impact of hyperglycemia in different age-groups of patients with acute myocardial infarction (AMI). RESEARCH DESIGN AND METHOD--A total of 2,027 patients with AMI were categorized into one of five age-groups: <50 years (n = 301), ≥50 and <60 (n = 477), ≥60...

  • Post-load hyperglycemia as an important predictor of long-term adverse cardiac events after acute myocardial infarction: a scientific study. Kitada, Shuichi; Otsuka, Yoritaka; Kokubu, Nobuaki; Kasahara, Yoichiro; Kataoka, Yu; Noguchi, Teruo; Goto, Yoichi; Kimura, Genjirou; Nonogi, Hiroshi // Cardiovascular Diabetology;2010, Vol. 9, p75 

    Background: Diabetes mellitus (DM) and impaired glucose tolerance (IGT) are risk factors for acute myocardial infarction (AMI). However, it is unknown whether hyperglycemic state is associated with increased major adverse cardiovascular events (MACE) after AMI. In this study, we evaluated the...

  • The Effects of Hyperglycemia On Patient Length of Stay Following Myocardial Infarction. Simpson, Jenny P.; Crane, Patricia B. // MEDSURG Nursing;Aug2005, Vol. 14 Issue 4, p233 

    The article presents information on a study that analyzes the effects of hyperglycemia on patient length of stay following myocardial infarction (MI). A computer-generated randomized list of 213 patients meeting the inclusion criteria and their medical record numbers was created by the medical...

  • Influence of admission plasma glucose level on short- and long-term prognosis in patients with ST-segment elevation myocardial infarction. Mladenović, Violeta; Zdravković, Vladimir; Jović, Marina; Vučić, Rada; Irić-Ćupić, Violeta; Rosić, Mirko // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Apr2010, Vol. 67 Issue 4, p291 

    Background/Aim. Hyperglicemia is common in patients with ST-elevation myocardial infarction (STEMI) and is associated with high risk of mortality and morbidity. Relationship between admission plasma glucose (APG) levels and mortality in diabetic and nondiabetic patients with STEMI needs further...

  • Key Global Literature. Fonseca, Vivian // Diabetes Care;Oct2004, Vol. 27 Issue 10, p2571 

    Presents an abstract of the article "Admission Blood Glucose Level as Risk Indicator of Death After Myocardial Infarction in Patients With and Without Diabetes Mellitus," by I. Stranders, M. Diamant, R. E. van Gelder, H. J. Spruijt, J. W. Twisk, R. J. Heine and F. C. Visser.

  • Clinical: Journals Watch - MI, hypertension and diabetes. Hunter, Simon // GP: General Practitioner;11/12/2010, p26 

    The article focuses on the study to determine the advantage of using coronary angiography and percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (MI) in Great Britain. It offers information on the impact of plasma glucose level on the patients who receives...

  • Treatment after acute MI in diabetics. Hoekzema, Grant S. // Journal of Family Practice;Sep1997, Vol. 45 Issue 3, p201 

    This article presents a study which examined whether intensive insulin therapy after acute myocardial infarction (MI) improve long-term survival in patients with diabetes mellitus. The primary study endpoint was the long-term all-cause mortality. Intravenous infusion of insulin-glucose...

  • Incidence and Clinical Course of Right Ventricular Infarction: Assessment with Radionuclide Ventriculography. Konishi, Tokuji; Khikawa, Takehiko; Yamamuro, Masashi; Koyama, Takan; Futagami, Yasuo; Nakano, Takeshi; Takezawa, Hideo // Angiology;Oct1987, Vol. 38 Issue 10, p741 

    The incidence and prognosis of right ventricular infarction were studied by radionuclide ventriculography (RNV) in 50 consecutive cases of acute myocardial infarction. RNV was performed within thirty-six hours of symptoms and one month after onset. Right ventricular infarction was absent in all...

  • Post-Infarct Left Ventricular Free Wall Rupture�Not Always a Lethal Complication of Acute Myocardial Infarction. Chen, Sylvia S.M.; Ruengsakulrach, Permyos; Dick, Ronald J.L.; Buxton, Brian F. // Heart, Lung & Circulation;Mar2004, Vol. 13 Issue 1, p26 

    Post-myocardial infarction cardiac rupture is an important complication and cause of death in the period following myocardial infarction. It is rarely diagnosed before death. However, early diagnosis is crucial as successful treatment is possible with surgery. A successful outcome is sometimes...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics