Key result
The presence of both admission blood glucose >186 mg/dL and eGFR <50 mL/min/1.73 m2 in octogenarians with acute myocardial infarction was associated with increased mortality (OR 4.2).
Why the study?
This study aimed to assess the long-term prognosis of octogenarians admitted with acute MI and evaluate the prognostic value of admission glucose blood level and eGFR.
Does the combination of admission blood glucose and eGFR improve risk stratification for mortality in octogenarians with acute myocardial infarction?
Observational (n=293)
Does the combination of admission blood glucose and eGFR improve risk stratification for mortality in octogenarians with acute myocardial infarction?
The combination of admission blood glucose >186 mg/dL and eGFR <50 mL/min/1.73 m2 significantly improves long-term mortality risk prediction in octogenarians with acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
May aid mortality risk stratification in octogenarian AMI; leaves open prospective validation before clinical use.
The aim of this observational study was to assess long-term prognosis of a contemporary octogenarian population admitted to an Intensive Cardiac Care Unit with acute myocardial infarction (MI), and the prognostic value of two simple biomarkers obtained at admission: glucose blood level (ABG) and estimated glomerular filtration rate (eGFR). A total of 293 consecutive patients were included (202 with ST elevation MI and 91 with non-ST elevation MI) with median age 83.9 years, 172 (58.7%) male. The optimal cut-off points for all-cause death defined by ROC curves were ABG >186 mg/dL and eGFR <50 mL/min/1.73 m2. The cohort was segregated into 3 groups according to these values: no biomarker present (group 1), either of the two biomarkers present (group 2) or both biomarkers present (group 3). Patients in group 3 were more frequently female, with worse Charlson index, Killip class and ventricular function, and higher GRACE scores. PCI was performed in 248 patients (84.6%). The highest in-hospital and long-term mortality, and composite MACE was observed in groups 2 and 3. All-cause mortality (median follow-up 2.2 years) was 44%. In multivariate analysis, ABG >186 mg/dL and eGFR <50 mL/min/1.73 m2 were associated with a 4.2 odds ratio (OR) (Model 1: medical history variables) and 2.6 OR (Model 2: admission event variables) of mortality. The addition of these variables to ROC curves improved long-term risk prediction for Model 1 (C-statistics 0.718 versus 0.780, p = 0.006) and reclassification and discrimination in both models.
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Sanz et al. (2021) conducted an observational in Acute myocardial infarction (n=293). Admission blood glucose >186 mg/dL and eGFR <50 mL/min/1.73 m2 vs. No biomarker present or only one biomarker present was evaluated on All-cause mortality (OR 4.2). The presence of both admission blood glucose >186 mg/dL and eGFR <50 mL/min/1.73 m2 in octogenarians with acute myocardial infarction was associated with increased mortality (OR 4.2).
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