TY - JOUR
T1 - Hyperglycemia during acute myocardial infarction in patients who are treated by primary percutaneous coronary intervention
T2 - Impact on long-term prognosis
AU - Lavi, Shahar
AU - Kapeliovich, Michael
AU - Gruberg, Luis
AU - Roguin, Ariel
AU - Boulos, Monther
AU - Grenadier, Ehud
AU - Amikam, Shlomo
AU - Markiewicz, Walter
AU - Beyar, Rafael
AU - Hammerman, Haim
PY - 2008/1/11
Y1 - 2008/1/11
N2 - 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.
AB - 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.
KW - Hyperglycemia
KW - Myocardial infarction
KW - Primary PCI
UR - http://www.scopus.com/inward/record.url?scp=37049029637&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37049029637&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2006.11.222
DO - 10.1016/j.ijcard.2006.11.222
M3 - Article
C2 - 17367882
AN - SCOPUS:37049029637
SN - 0167-5273
VL - 123
SP - 117
EP - 122
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -