Key result
Elevated admission blood glucose (≥10.7 mmol/L) was associated with an increased risk of 30-day MACEs in AMI patients (OR 1.86), a relationship found only in STEMI patients, not in NSTEMI patients.
Why the study?
Although elevated admission blood glucose is linked to adverse outcomes in AMI, its association with 30-day MACE had not been evaluated separately in STEMI versus NSTEMI patients.
Does elevated admission blood glucose increase the risk of 30-day MACEs in patients with AMI, and does this differ between STEMI and NSTEMI?
Cohort (n=13,398)
Yes
Does elevated admission blood glucose increase the risk of 30-day MACEs in patients with AMI, and does this differ between STEMI and NSTEMI?
Odds Ratio: 1.86 (95% CI 1.36–2.56)
Absolute Event Rate: 6.55% vs 3.54%
p-value: p=<0.001
Elevated admission blood glucose is an independent risk factor for 30-day MACEs in patients with STEMI, but not NSTEMI, highlighting the need for targeted risk stratification and glycemic monitoring in STEMI patients.
Supports admission glucose for STEMI risk stratification; leaves open causal effects and benefit of intervention.
BackgroundElevated admission blood glucose was associated with adverse outcomes in patients with acute myocardial infarction (AMI). However, no further studies investigated the association between admission blood glucose and 30-day major adverse cardiovascular outcomes (MACEs) in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) patients, respectively.ObjectivesThe purpose of this study was to evaluate the impact of admission blood glucose on the risk of 30-day major adverse cardiovascular events in AMI patients, and to assess the difference in outcome between STEMI and NSTEM patients.Methods and ResultsThis study was a post hoc analysis of the Acute Coronary Syndrome Quality Improvement in Kerala (ACS-QUIK) Study, and 13,398 participants were included in the final analysis. Participants were divided according to the admission blood glucose quintiles. Compared with participants with admission blood glucose between 5.4 and 6.3 mmol/L, participants with the highest quintile of admission blood glucose (≥ 10.7 mmol/L) were associated with increased risk of 30-day MACEs in the fully adjusted logistic regression model [adjusted OR (95%CI): 1.86 (1.36, 2.56), P<0.001]. There was a positive linear association between admission blood glucose and the risk of 30-day MACEs in AMI patients [adjusted OR (95%CI): 1.05 (1.03, 1.07), P<0.001]. This trend was more significant in patients with STEMI (P for interaction = 0.016) or patients below 65 years old (P for interaction = 0.025).ConclusionIn patients with AMI, elevated admission blood glucose was associated with the increased risk of 30-day MACEs, and this relationship was found only in STEMI patients, not in NSTEMI patients.
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Li et al. (2022) conducted a cohort in Acute myocardial infarction (AMI) (n=13,398). Elevated admission blood glucose (≥ 10.7 mmol/L) vs. Admission blood glucose 5.4-6.3 mmol/L was evaluated on 30-day major adverse cardiovascular events (MACEs) (OR 1.86, 95% CI 1.36-2.56, p=<0.001). Elevated admission blood glucose (≥10.7 mmol/L) was associated with an increased risk of 30-day MACEs in AMI patients (OR 1.86), a relationship found only in STEMI patients, not in NSTEMI patients.
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