Hyperglycemia during acute myocardial infarction in patients who are treated by primary percutaneous coronary intervention: Impact on long-term prognosis

Shahar Lavi, Michael Kapeliovich, Luis Gruberg, Ariel Roguin, Monther Boulos, Ehud Grenadier, Shlomo Amikam, Walter Markiewicz, Rafael Beyar, Haim Hammerman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Transient hyperglycemia is common during acute myocardial infarction in non-diabetic patients and is associated with a worse outcome. There is limited data on the outcome of patients who undergo primary percutaneous coronary intervention and have transient hyperglycemia. Methods: Fasting plasma glucose was measured in 431 consecutive acute myocardial infarction patients who underwent primary percutaneous coronary interventions. Patients were classified into three groups: non-diabetics/non-hyperglycemic (NDNH, glucose <126 mg/dL; n = 224); non-diabetics/hyperglycemic (NDH, glucose ≥ 126 mg/dL; n = 119); and diabetics (n = 88). Data were analyzed according to the different groups and according to exact glucose levels. Results: In-hospital mortality was significantly lower in NDNH (1%) compared to NDH (8%) and diabetic (5%) patients (p = 0.01). One-year cumulative mortality was highest (10%) in patients with NDH (p <0.001). One year target lesion revascularization rates were identical in NDNH and NDH patients (6% vs. 8%) and higher in diabetic patients (19%, p = 0.001). In a multivariate model, a striking increase in the risk of death (0.6%, p = 0.05) and target lesion revascularization (2%, p <0.0001) was found for every increment of 1 mg/dL in glucose level. Conclusions: Transient hyperglycemia in non-diabetic acute myocardial infarction patients who undergo primary percutaneous coronary interventions is associated with high one-year mortality. One year target lesion revascularization rates were significantly higher in diabetics compared to non-diabetics with normoglycemia or transient hyperglycemia.

Original languageEnglish (US)
Pages (from-to)117-122
Number of pages6
JournalInternational Journal of Cardiology
Volume123
Issue number2
DOIs
StatePublished - Jan 11 2008
Externally publishedYes

Keywords

  • Hyperglycemia
  • Myocardial infarction
  • Primary PCI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Hyperglycemia during acute myocardial infarction in patients who are treated by primary percutaneous coronary intervention: Impact on long-term prognosis'. Together they form a unique fingerprint.

Cite this