The relationship between stress hyperglycemia and the prognosis of acute myocardial infarction without diabetes mellitus
10.3760/cma.j.cn115455-20230411-00354
- VernacularTitle:应激性高血糖与非糖尿病急性心肌梗死预后相关性研究
- Author:
Chang MA
1
;
Tian ZHOU
;
Hao ZHANG
;
Xuexue HAN
;
Tianxing ZHANG
;
Qinxue LI
;
Jinggang XIA
Author Information
1. 首都医科大学宣武医院心脏内科 国家老年疾病临床医学研究中心，北京 100053
- Keywords:
Myocardial infarction;
Prognosis;
Disease management;
Stress hyperglycemia
- From:
Chinese Journal of Postgraduates of Medicine
2023;46(11):1003-1009
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the relationship between stress hyperglycemia (SHG) and the prognosis of acute myocardial infarction (AMI) without diabetes mellitus (DM).Methods:Using a retrospective cohort study method, 396 AMI patients without DM or impaired glucose tolerance (IGT) and admitted glycated hemoglobin A 1c (HbA 1c)≤6.0% from January 2018 to December 2020 in Xuanwu Hospital, Capital Medical University were selected. Among them, 238 patients did not have SHG at admission (group A), 85 patients had SHG at admission but their blood glucose level did not reach the diagnostic criteria for DM (group B), and 73 patients had SHG at admission and their blood glucose level reached the diagnostic criteria for DM (group C). The baseline data and the incidence of main adverse cardiovascular and cerebrovascular events (MACCE) were recorded. Multivariate Cox regression was used to analyze the independent risk factors of MACCE after discharge in AMI patients without DM. Results:The incidence of MACCE after discharge in group B and group C was significantly higher than that in group A: 29.4% (25/85) and 35.6% (26/73) vs. 18.5% (44/238), the incidence in group C was significantly higher than that in group B, and there was statistical difference ( P<0.05). Multivariate Cox regression analysis result showed that SHG on admission was an independent risk factor for MACCE after discharge in AMI patients without DM ( P<0.05), and LVEF on admission was an independent protective factor for MACCE after discharge in AMI patients without DM ( P<0.01). Conclusions:SHG on admission is the independent risk factor of MACCE in AMI patient without DM. Early detection, assessment and proper intervention measures based on clinical reality should be advocated for the AMI patients with SHG to further improve the prognosis.
