Key result
STEMI patients presenting with hyperglycemia on admission had a higher rate of in-hospital mortality compared to those with euglycemia.
Why the study?
Elevated blood glucose levels on hospital admission may influence outcomes in patients with STEMI, prompting evaluation of its prognostic value with and without T2DM.
Does hyperglycemia on admission increase in-hospital mortality in patients presenting with STEMI?
Cohort (n=256)
No
Does hyperglycemia on admission increase in-hospital mortality in patients presenting with STEMI?
Hyperglycemia on admission is a significant prognostic marker for increased in-hospital mortality in patients presenting with STEMI, regardless of prior diabetes status.
Answers are grounded in this paper and cite their sources.
Admission hyperglycemia identifies higher in-hospital mortality risk in STEMI; extends evidence on admission glucose as a prognostic marker.
Background Type 2 diabetes mellitus (T2DM) is associated with acute coronary syndrome, and elevated blood glucose levels on hospital admission may influence outcomes in patients with ST-elevated myocardial infarction (STEMI). We conducted this study to determine the prognostic outcome of hyperglycemia at admission on in-hospital outcomes of STEMI patients with and without T2DM. Methods This prospective study was conducted from June 13, 2018, to October 12, 2019, and included patients older than 18 years diagnosed with STEMI. For our purposes, hyperglycemia was defined as blood glucose levels >140 mg/dl. Hypertension was considered as systolic blood pressure >140 mmHg or diastolic pressure > 90 mmHg. The predictive value of glycemia on admission for outcomes was assessed via patient mortality following thrombolysis or percutaneous coronary intervention (PCI). Results Our study included 256 patients (196 men, 76.5%; 60 women, 23.5%) with a mean age of 55 ± 11 years. A total of 92 patients (35.9%) were admitted with known T2DM diagnoses: 72 of them had hyperglycemia and 20 patients had euglycemia (p = 0.0001). Post-PCI mortality was six (18.8%) in the hyperglycemic group and one (2.2%) in the euglycemic group (p = 0.03). In-hospital mortality was higher in the hyperglycemic group (n = 12, 12.5%) compared to the euglycemic group (n = 6, 3.7%; p = 0.015). Significant risk factors of mortality for STEMI patients with hyperglycemia on admission were age 60 years or older (odds ratio [OR], 5.63 [1.54-20.58]; p = 0.007), heart failure on admission (OR, 6.84 [1.85-25.22)]; p = 0.003), T2DM (OR, 4.14 [0.50-33.96]; p = 0.05), and presenting with renal failure (OR, 6.78 [1.74-26.42]; p = 0.009). Conclusion Thrombolysis and PCI are effective and safe treatments in STEMI patients. Hyperglycemia has a great adverse impact on hospital outcomes in patients with or without T2DM. STEMI patients with hyperglycemia on hospital admission have higher mortality rates.
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Shahid et al. (2020) conducted a cohort in ST-elevation Myocardial Infarction (n=256). Hyperglycemia on admission vs. Euglycemia on admission was evaluated on In-hospital mortality (p=0.015). STEMI patients presenting with hyperglycemia on admission had a higher rate of in-hospital mortality compared to those with euglycemia.
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