Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction patients with or without known diabetes
10.3760/cma.j.issn.0253-3758.2009.07.006
- VernacularTitle:入院血糖水平对糖尿病和非糖尿病ST段抬高急性心肌梗死患者预后的影响
- Author:
Yao LIU
1
;
Yan-Min YANG
;
Jun ZHU
;
Hui-Qiong TAN
;
Yan LIANG
;
Li-Sheng LIU
;
Ying LI
Author Information
1. 中国医学科学院北京协和医学院阜外心血管病医院
- Keywords:
Myocardial infarction;
Diabetes mellitus;
Prognosis;
Mortality
- From:
Chinese Journal of Cardiology
2009;37(7):590-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the impact of admission blood glucose level on 30-day mortality in ST-segment elevation acute myocardial infarction (STEMI) patients with or without known diabetes. Method This observational analysis enrolled 7446 Chinese STEMI patients hospitalized within 12 hours of symptom onset joining a global randomized controlled trial. The patients with or without known diabetes were divided into different groups by the admission blood glucose level : < 6. 1 mmol/L (n = 2018), 6. 1 to 7.7 mmoL/L (n=2170), 7.8 to 11.0 mmol/L (n=1929), 11.1 to 13.0 mmol/L (n =465), >13.0 mmol/L (n = 864), the last three groups were defined as the hyperglycemia group. The 30-day mortality was analyzed. Result A substantial proportion of hyperglycemic patients did not have recognized diabetes. Insulin use during hospitalization in hyperglycemic patients without known diabetes was significantly lower than that in known diabetics with similar glucose levels. Incidence of 30-day mortality increased in proportion to increasing admission glucose levels in patients without known diabetes (glucose < 6. 1 mmol/L 6.8%, 6.1 to 7.7 mmol/L 8.3% ,glucose > 13.0 mmol/L 18.6%, P <0.001). In patients with known diabetes, the 30-day mortality was 16.7% with admission glucose <6.1 mmol/L and 8.2% with admission glucose 6.1 to 7.7 mmol/L, and 22.0% with admission glucose > 13.0 mmoL/L(P < 0. 001). Except in patients with admission glucose > 13, 0 retooL/L, the 30-day mortality was significantly higher in patients without known diabetes than in patients with known diabetes at comparable admission glucose levels (all P <0.05). Conclusion Comparing with the known diabetic patients, admission hyperglycemia is common in STEMI patients without known diabetes and was associated with higher 30-day mortality compared to known diabetes patients with comparable admission glucose level with the exception of admission glucose level > 13.0 mmoL/L.
