Patients with a myocardial infarction and hyperglycemia at admission have an increased 1-year mortality rate that is similar to the rate seen in patients with diabetes at admission.
A group of researchers led by Professor François Schiele of the University Hospital Jean Minjoz in Besançon, France, evaluated whether hyperglycemia at admission was a risk factor for mortality in patients with acute myocardial infarction. A total of 320 patients with ST-segment elevation myocardial infarction (STEMI) and 404 with non-ST-segment elevation myocardial infarction (NSTEMI) were assessed. Data were recorded on first fasting plasma glucose (FPG) concentration at admission, risk score according to the Global Registry of Acute Coronary Events (GRACE), adherence to treatment guidelines, and 1-year mortality. Hyperglycemia at admission was defined as FPG>138mg/dL (7.7 mmol/L.).
The researchers found that 24% of patients had diabetes, 21% had hyperglycemia, and 55% were euglycemic at admission. The 1-year mortality rate was higher in those with hyperglycemia than in those with euglycemia (18.8% vs 6.1%; p<0.01), and similar to those with diabetes (18.8% vs 16.6%; p=NS). The relationship between glycemic status and mortality remained strong after adjusting for GRACE risk score and adherence to treatment guidelines.
The researchers concluded that, among patients with STEMI or NSTEMI, those with hyperglycemia at admission have an increased 1-year mortality rate that is similar to the rate seen in patients with diabetes at admission.