Key result
Stress hyperglycemia linked to higher in-hospital mortality, stent thrombosis, and MACE in nondiabetic STEMI patients.
Why the study?
The relationship between stress hyperglycemia and in-hospital stent thrombosis in nondiabetic STEMI patients undergoing primary PCI is rarely studied.
Does stress hyperglycemia increase the risk of in-hospital stent thrombosis and adverse prognosis in nondiabetic patients with STEMI undergoing primary PCI?
Cohort (n=853)
Does stress hyperglycemia increase the risk of in-hospital stent thrombosis and adverse prognosis in nondiabetic patients with STEMI undergoing primary PCI?
p-value: p=0.045 for mortality, 0.038 for ST, 0.008 for MACE
Stress hyperglycemia on admission is an independent predictor of in-hospital mortality, stent thrombosis, and MACE in nondiabetic patients presenting with STEMI and undergoing primary PCI.
May warrant closer monitoring but should not change practice; leaves open whether targeting stress hyperglycemia improves outcomes in nondiabetic STEMI.
OBJECTIVE: Stress hyperglycemia (SH) in a setting of acute myocardial infarction increases the risk of in-hospital mortality. The relationship between SH and in-hospital stent thrombosis (ST) is rare. The aim of our study was to assess the impact of SH on in-hospital ST and prognosis in nondiabetic patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (p-PCI). PATIENTS AND METHODS: This study included 853 patients without diabetes mellitus with STEMI. All patients were treated with p-PCI. Blood glucose (BG) was measured on admission. The patients were divided into two groups on the basis of admission BG (SH, BG≥180 mg/dl; non-SH, BG<180 mg/dl). The two groups were compared with respect to baseline characteristics and primary endpoints. RESULTS: During hospitalization, all-cause mortality was 2.9%. The total incidence of ST was 1.9%. Patients with SH experienced a significantly higher incidence of mortality (P=0.045), ST (P=0.038), and composite major adverse cardiac events (MACE) (P=0.008) than patients without SH. Patients with SH extended hospital days (P<0.001). After multivariate analysis, SH was associated independently with in-hospital mortality, incidence of ST, and composite MACE. CONCLUSION: In nondiabetic patients with STEMI undergoing p-PCI, the patients with SH experienced a significantly higher incidence of mortality, ST, and composite MACE.
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Zhang et al. (2013) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=853). Stress hyperglycemia (admission blood glucose ≥180 mg/dl) vs. Non-stress hyperglycemia (admission blood glucose <180 mg/dl) was evaluated on In-hospital mortality, stent thrombosis (ST), and composite major adverse cardiac events (MACE) (p=0.045 for mortality, 0.038 for ST, 0.008 for MACE). In nondiabetic patients with STEMI undergoing primary PCI, stress hyperglycemia was associated with higher in-hospital mortality (P=0.045), stent thrombosis (P=0.038), and MACE (P=0.008).
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