Key result
Admission hyperglycemia (>145 mg/dL) in non-diabetic patients undergoing primary PCI was associated with a significantly higher risk of inhospital MACE compared to normoglycemia (OR 9.55, P<0.02).
Why the study?
Does admission hyperglycemia predict inhospital mortality and major adverse cardiac events in non-diabetic patients undergoing primary PCI for STEMI?
Cohort (n=503)
Does admission hyperglycemia predict inhospital mortality and major adverse cardiac events in non-diabetic patients undergoing primary PCI for STEMI?
Admission hyperglycemia is a strong predictor of inhospital mortality, cardiogenic shock, and major adverse cardiac events in non-diabetic patients undergoing primary PCI for STEMI.
Supports admission glucose monitoring in non-diabetic primary PCI patients; leaves open whether targeting hyperglycemia improves outcomes.
Admission hyperglycemia is associated with high inhospital and long-term adverse events in patients that undergo primary percutaneous coronary intervention (PCI). We aimed to evaluate whether hyperglycemia predicts inhospital mortality. We prospectively analyzed 503 consecutive patients. The patients were divided into tertiles according to the admission glucose levels. Tertile I: glucose <118 mg/dL (n = 166), tertile II: glucose 118 to 145 mg/dL (n = 168), and tertile III: glucose >145 mg/dL (n = 169). Inhospital mortality was 0 in tertile I, 2 in tertile II, and 9 in tertile III (P < .02). Cardiogenic shock occurred more frequently in tertile III compared to tertiles I and II (10% vs 4.1% and 0.6%, respectively, P = .01). Multivariate logistic regression analysis revealed that patients in tertile III had significantly higher risk of inhospital major adverse cardiac events compared to patients in tertile I (odds ratio: 9.55, P < .02). Admission hyperglycemia predicts inhospital adverse cardiac events in mortality and acute ST-segment elevation myocardial infarction in patients that underwent primary PCI.
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Ekmekçi et al. (2013) conducted a cohort in Acute ST-segment elevation myocardial infarction without diabetes mellitus (n=503). Admission hyperglycemia (glucose >145 mg/dL) vs. Glucose <118 mg/dL was evaluated on Inhospital major adverse cardiac events (OR 9.55, p=<0.02). Admission hyperglycemia (>145 mg/dL) in non-diabetic patients undergoing primary PCI was associated with a significantly higher risk of inhospital MACE compared to normoglycemia (OR 9.55, P<0.02).
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