Abstract:
Introduction: In patients with acute myocardial infarction, elevation of plasma glucose levels
is associated with worse outcomes.
Purpose and Objectives: The aim of this study was to evaluate the prevalence of newly hyperglycemia and the association between admission hyperglycemia and in-hospital m ortality in
patients with acute myocardial infarction (AMI).
Materials and Methods: Retrospective observational study included 125 consecutive patients
(<70yo) with AMI hospitalized at “Sfinta Treime” Municipal Hospital, Chisinau, in period 1.01.2012-
31.12.2012. Patients with known diabetes mellitus (n=25) or non-diabetic with fasting hyperglycemia
(n=17) were excluded, while those with previous myocardial infarction or stroke were enrolled.
The study sample was divided into normoglycemic patients (NDN; n=50; fasting glucose
<6.1mmol/l and 2-h post-load glucose <7.8mmol/l) and those with admission hyperglycemia (NDH,
n=33), without previous history of diabetes (admission glucose >7.8mmoI/l).
Data were analyzed in MS Excel (2010). Results are presented as means and SD. Pearson correlation coefficient (r) was determined for each variable and p<0.05 was considered statistically significant.
Results: The results of the present investigation confirm that, even among non-diabetic patients,
the prevalence of elevated glucose levels upon admission for AMI is high (n=33; 33%), the prevalence
was higher in men (21 vs. 12). Compared to normoglycemic, NDH patients were younger (53.64yo vs.
57.30). As expected, mortality were significant lower in NDN (n=2; 4% vs. n=10; 30%). Mortality was
higher in males (7 vs. 3 in NDH; 2 vs. 0 in NDN). In NDH group death occurred predominantly in
younger group (9 patients <60yo and 1 person >60yo, compared to 1:1 in NDN). In both groups,
admission glucose levels were higher in non-survivors (5.68±1.24 vs. 5.64±0.92 in NDN and
10.85±2.44 vs. 10.13±2.34 in NDH; p<0.001). A strong uphill correlation was observed between
admission glucose and mortality (r-coefficient 0.53). NDH had longer hospital stay (456.00±30.99h vs.
426.00h±21.08; p<0.001). Death occurred earlier in NDH (37.66h±15.19 vs. 72.70h, p<0.05).
It suggests that the presence of hyperglycemia in subjects who present with AMI offers a
survival disadvantage.
Conclusions: Hyperglycemia on admission is an independent predictor of poor in-hospital
outcome and mortality in AMI and could be used in the stratification of risk in these patients. The
impact of hyperglycemia as a risk factor in AMI is more pronounced in younger patients (<60yo)
compared to those older than 60yo.
Description:
Department of Endocrinology, “Sfinta Treime” Municipal Hospital, Chisinau,
Republic of Moldova
