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Hyperglycemia levels may help predict short and long-term outcomes in acute MI patients
![Hyperglycemia levels may help predict short and long-term outcomes in acute MI patients Hyperglycemia levels may help predict short and long-term outcomes in acute MI patients](https://medicaldialogues.in/h-upload/2020/02/06/750x450_124061-heart-attack-1.webp)
China: Regardless of diabetes status, entry hyperglycemia is a key predictor of short and long-term outcomes in acute myocardial infarction (AMI) patients, says an article published in BMC - Cardiovascular Diabetology.
In patients with acute myocardial infarction, admission hyperglycemia is linked with a poor prognosis, although the implications of baseline diabetes status on this connection remain unknown. As a result, Hanzohra Upur and colleagues designed this study to look at the influence of admission hyperglycemia on short and long-term results in diabetic and non-diabetic AMI patients.
Between July 2012 and July 2020, 3330 individuals with first-time AMI were identified in this retrospective cohort analysis. The participants were separated into two groups based on their diabetes status (1060 diabetic patients and 2270 non-diabetic patients). They were then separated into four groups based on diabetes status-specific fasting blood glucose (FBG) cutoff levels established by a limited cubic spline. In-hospital mortality and heart problems were among the short-term outcomes.
All-cause mortality and significant adverse cardiovascular events were the long-term outcomes (MACE). To account for baseline differences between groups, inverse probability of treatment weighting (IPTW) was used, followed by a weighted Cox proportional hazards regression analysis to quantify hazard ratios and 95% confidence intervals for all-cause mortality related to each FBG category.
The key findings of this study were as follows:
1. 837 people died over a median follow-up of 3.2 years.
2. During long-term follow-up, there was a significant interaction between diabetes status and FBG levels for all-cause death (p-interaction 0.001).
3. Furthermore, limited cubic spline curves for the link between FBG and all-cause mortality resembled a J shape in diabetics and a non-linear form in non-diabetics.
4. A Kaplan-Meier study revealed that non-hyperglycemia patients outlived hyperglycemia patients in both diabetic and non-diabetic patient groups.
5. Patients with hyperglycemia who do not have diabetes had a higher survival rate than patients with hyperglycemia who do have diabetes.
6. Admission hyperglycemia predicted greater short and long-term mortality in the weighted Multivariable Cox analysis.
7. The robustness of the data was demonstrated by subgroup analysis and sensitivity analysis.
FBG levels of 5.60 mmol/L for individuals without diabetes and 10.60 mmol/L for those with diabetes were the inflection points for poor prognosis. Admission hyperglycemia was found to be an independent predictor of poor short and long-term results in AMI patients with and without diabetes. The authors suggested that the key findings of this study merit additional investigation.
Reference:
Upur, H., Li, J.-L., Zou, X.-G., Hu, Y.-Y., Yang, H.-Y., Abudoureyimu, A., Abliz, A., Abdukerim, M., & Huang, M. (2022). Short and long-term prognosis of admission hyperglycemia in patients with and without diabetes after acute myocardial infarction: a retrospective cohort study. In Cardiovascular Diabetology (Vol. 21, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12933-022-01550-4
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Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751