Admission hyperglycemia in MI patients may increase risk of death and adverse CV events: Study
Iran: Non-diabetic patients with a diagnosis of first-ever myocardial infarction (MI) admitted to hospital with stress hyperglycemia are at increased risk of in-hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCEs), a recent study has found. Further, older ages, elevated ABS, and a decreased value of baseline LVEF predicted MACCE during follow-up. The findings appear in the Romanian Journal of Internal Medicine.
Acute coronary syndrome (ACS) consists of a full spectrum of clinical manifestations from unstable angina to acute myocardial infarction (MI). About half of the patients with suspected ACS are shown to have hyperglycemia in the emergency department. Diabetes patients with ACS have worse outcomes compared with those with normal blood glucose levels or impaired glucose regulation.
Admission hyperglycemia has been associated with major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome.
Ramin Eskandari, Department of Cardiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran, and colleagues sought to determine the association between admission blood sugar (ABS) and the outcomes of non-diabetic patients with first-ever acute myocardial infarction.
For this purpose, the researchers evaluated non-diabetic patients with MI from March 2016 to March 2019. They recorded baseline characteristics, laboratories, electrocardiogram, and baseline left ventricular ejection fraction (LVEF). All patients were followed up and outcomes were obtained. Follow-up data comprised of repeating electrocardiogram and echocardiography at 1 year, and MACCE, including re-MI, stroke, and mortality.
A total of 312 patients with a mean age of 54.2 ± 11.9 years were evaluated.
The research yielded the following findings:
- All patients were followed up for a median of 38 months.
- The frequencies of in-hospital mortality and MACCE at late follow-up were higher in third tertile of ABS compared with those in first and second tertiles.
- Based on the Cox regression analysis, the independent predictors of MACCE included age (hazard ratio [HR] 1.068, third tertile of ABS >172 mg/dL (HR 21.257), and baseline LVEF (HR 0.947).
Our observational study showed that admission stress hyperglycemia was significantly associated with increased rates of in-hospital mortality and of MACCE at late follow-up period in non-diabetic patients with first-ever acute MI, the authors concluded.
The study titled, "Association between admission blood glucose and prognosis in non-diabetic patients with first-ever acute myocardial infarction," is published in the Romanian Journal of Internal Medicine.