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Prognostic implications of stress hyperglycemia in acute ST elevation myocardial infarction. Prospective observational study
- Source :
- Revista espanola de cardiologia. 64(3)
- Publication Year :
- 2010
-
Abstract
- Introduction and objectives: In patients with acute myocardial infarction, elevation of plasma glucose levels is associated with worse outcomes. The aim of this study was to evaluate the association between stress hyperglycemia and in-hospital mortality in patients with acute myocardial infarction with STsegment elevation (STEMI). Methods: We analyzed 834 consecutive patients admitted for STEMI to the Coronary Care Unit of our center. Association between admission glucose and mortality was assessed with Cox regression analysis. Discriminative accuracy of the multivariate model was assessed by Harrell’s C statistic. Results: Eighty-nine (10.7%) patients died during hospitalization. Optimal threshold glycemia level of 140 mg/dl on admission to predict mortality was obtained by ROC curves. Those who presented glucose 140 mg/dl showed higher rates of malignant ventricular tachyarrhythmias (28% vs. 18%, P = .001), complicative bundle branch block (5% vs. 2%, P = .005), new atrioventricular block (9% vs. 5%, P = .05) and in-hospital mortality (15% vs. 5%, P < .001). Multivariate analysis showed that those with glycemia 140 mg/dl exhibited a 2-fold increase of in-hospital mortality risk (95% CI: 1.2-3.5, P = .008) irrespective of diabetes mellitus status (P-value for interaction = 0.487 and 0.653, respectively). Conclusions: Stress hyperglycemia on admission is a predictor of mortality and arrhythmias in patients with STEMI and could be used in the stratification of risk in these patients.
- Subjects :
- Adult
Male
medicine.medical_specialty
Myocardial Infarction
Stress hyperglycemia
Stress, Physiological
Internal medicine
Diabetes mellitus
medicine
Humans
Myocardial infarction
Prospective Studies
Prospective cohort study
Aged
Aged, 80 and over
Bundle branch block
Proportional hazards model
business.industry
General Medicine
Middle Aged
medicine.disease
Prognosis
Hyperglycemia
Cardiology
Coronary care unit
Myocardial infarction complications
Female
business
Subjects
Details
- ISSN :
- 15792242
- Volume :
- 64
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Revista espanola de cardiologia
- Accession number :
- edsair.doi.dedup.....7cb612acb7bb5ca0e6112a77a7e1ec7d