Impact of Admission Blood Glucose on 48-Hour Mortality and Complications in Non-Diabetic Patients with Acute Myocardial Infarction

INTRODUCTION: Stress hyperglycemia is a common physiological response during acute myocardial infarction (AMI), even among non-diabetic patients. Elevated admission blood glucose has been associated with early mortality, ventricular arrhythmias, and major adverse cardiac events (MACE). However, data from small, resource-limited intensive care settings remain limited. OBJECTIVES: To evaluate the impact of admission blood glucose levels on 48-hour mortality and major cardiac complications among non-diabetic AMI patients admitted to ICU. MATERIALS AND METHODS: A prospective observational study was conducted in an ICU setting on 33 non-diabetic AMI patients. Patients were stratified into three groups based on admission blood glucose: Group 1: <120 mg/dL Group 2: 121–179 mg/dL Group 3: ≥180 mg/dL CLINICAL OUTCOMES ASSESSED WITHIN 48 HOURS INCLUDED: 1. Mortality. 2. Major Adverse Cardiac Events (MACE) – ventricular arrhythmias, cardiogenic shock, acute heart failure, need for inotropes, Statistical analysis included descriptive statistics and Fisher's exact test for comparison of proportions. Risk ratios (RR) with 95% confidence intervals (CI) were calculated. RESULTS: Among the 33 enrolled patients, Group 3 demonstrated the worst outcomes. In Group 3, 2 patients died within 48 hours, both due to ventricular fibrillation. MACE occurred in 6 patients in Group 3. In Group 2, 3 patients developed MACE, and no 48-hour deaths were recorded. Group 1 had no deaths and minimal complications (data not shown in the original dataset). Patients with glucose ≥180 mg/dL had a significantly higher incidence of combined adverse outcomes compared with lower glucose groups. Risk of MACE was higher in Group 3 compared to Group 2 (RR ≈ 1.8; 95% CI wide due to small sample). 48-hour mortality was exclusively observed in Group 3. Fisher's exact test showed a statistically significant trend toward worse outcomes in the high-glucose group, although small sample size limited power. Overall, higher admission glucose strongly correlated with early VF, hemodynamic instability, and short-term mortality. CONCLUSION: Elevated admission blood glucose (≥180 mg/dL) in non-diabetic AMI patients is associated with substantially higher 48-hour mortality and major cardiac complications. Stress hyperglycemia is a strong early prognostic marker and should be considered in initial risk stratification. Larger multicenter studies are needed to validate these findings and to evaluate whether early glycemic control improves outcomes.