What question did this study set out to answer?

To determine whether persistent hyperglycemia during the initial days of acute myocardial infarction is a superior predictor of 30-day adverse cardiac outcomes compared with admission glucose alone.

January 1, 2007Cardiovascular DiabetologyOpen Access

Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction

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Why the study?

Does persistent hyperglycemia better predict 30-day MACE than admission glucose in patients with acute myocardial infarction treated with primary PCI?

Population

417 patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Comparison

Persistent hyperglycemia vs Admission glucose

Design

Cohort

Follow-up

30 days

Authors

IHIwan CC van der HorstMaastricht University Medical Centre MNMaarten W. NijstenApple (Israel)MVMathijs VogelzangUniversity Medical Center Groningen

Discussion

Member takes

Implication

May refine 30-day MACE risk stratification after primary PCI; hypothesis-generating and should not yet change practice.

Key Points

To determine whether persistent hyperglycemia during the initial days of acute myocardial infarction is a superior predictor of 30-day adverse cardiac outcomes compared with admission glucose alone.
Conducted a prospective study of 417 patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
Obtained serial blood glucose measurements (mean of 7.4 determinations per patient) during the first two days after hospital admission.
Assessed major adverse cardiac events (MACE) at 30 days, defined as all-cause mortality, recurrent infarction, repeat coronary intervention, or left ventricular ejection fraction ≤30%.
MACE occurred in 89 of 417 patients (21.3%), of which 17 events (4.1%) were fatal.
Mean two-day glucose was significantly elevated in patients experiencing MACE compared to event-free patients (9.0 ± 2.8 mmol/L vs. 8.1 ± 2.0 mmol/L, P < 0.0001), yielding a higher area under the ROC curve than admission glucose (0.64 vs. 0.59).
Persistent hyperglycemia remained a significant independent predictor of 30-day MACE (P < 0.001), demonstrating a stronger association with adverse outcomes than admission glucose alone.

Structured PICO

Does persistent hyperglycemia better predict 30-day MACE than admission glucose in patients with acute myocardial infarction treated with primary PCI?

Population

417 patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Intervention

Persistent hyperglycemia (mean glucose during the first two days after admission)

Comparator

Admission glucose

Outcome

Major adverse cardiac events (MACE) at 30 days follow-up, defined as death, recurrent infarction, repeat primary coronary intervention, and left ventricular ejection fraction ≤30%composite

Persistent hyperglycemia during the first two days after admission is a stronger predictor of 30-day MACE than a single admission glucose measurement in patients with acute myocardial infarction.

Cite This Study

Horst et al. (2007) studied this question.

synapsesocial.com/papers/6a76a258656dd99464ec2476 https://doi.org/10.1186/1475-2840-6-2

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Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider