Key result
Admission hyperglycemia in non-diabetic patients undergoing percutaneous coronary intervention for acute myocardial infarction was associated with significantly increased in-hospital mortality (OR 2.29) compared to non-diabetics without admission hyperglycemia.
Why the study?
Does admission hyperglycemia increase in-hospital mortality in patients undergoing emergency PCI for acute myocardial infarction?
Observational (n=849)
Yes
Does admission hyperglycemia increase in-hospital mortality in patients undergoing emergency PCI for acute myocardial infarction?
Admission hyperglycemia is a significant independent predictor of in-hospital mortality in patients undergoing emergency PCI for AMI, regardless of whether they have a prior diagnosis of diabetes.
May support risk stratification by admission glucose in non-diabetic AMI PCI patients; leaves open whether intervention improves outcomes.
BACKGROUND: The effects of glucose abnormalities on outcomes after percutaneous coronary intervention (PCI) remain unclear. We examined the association between glucose abnormalities and in-hospital outcome in patients undergoing PCI for acute myocardial infarction (AMI). METHODS AND RESULTS: A total of 849 patients with AMI who were admitted within 12 h after symptom onset and underwent emergency PCI were classified according to the presence or absence of admission hyperglycemia, defined as a blood glucose level on admission of >11 mmol/L and whether they had a history of diabetes mellitus: group 1 (n = 504), non-diabetic patients without admission hyperglycemia; group 2 (n = 111), diabetic patients without admission hyperglycemia; group 3 (n = 87), non-diabetic patients with admission hyperglycemia; and group 4 (n = 147), diabetic patients with admission hyperglycemia. Among groups 1, 2, 3 and 4, in-hospital mortality was 2.6, 2.7, 11.5 and 8.8%, respectively (p < 0.01). Multivariate analysis showed that compared with group 1 patients, the odds ratio (95%confidence interval) for in-hospital mortality among those in groups 2, 3, and 4 were 0.80 (0.24-2.60, p = 0.708), 2.29 (1.10-5.49, p = 0.039), and 2.14 (1.14-4.69, p = 0.048), respectively. CONCLUSIONS: In-patients undergoing PCI for AMI, admission hyperglycemia, irrespective of the presence or absence of diabetes, is associated with increased in-hospital mortality, whereas diabetes without admission hyperglycemia is not.
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Kosuge et al. (2005) conducted an observational in Acute myocardial infarction (AMI) (n=849). Admission hyperglycemia (>11 mmol/L) vs. Absence of admission hyperglycemia was evaluated on In-hospital mortality (OR 2.29, 95% CI 1.10-5.49, p=0.039). Admission hyperglycemia in non-diabetic patients undergoing percutaneous coronary intervention for acute myocardial infarction was associated with significantly increased in-hospital mortality (OR 2.29) compared to non-diabetics without admission hyperglycemia.
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