Abstract 15342: Predictive Value of Glucose Levels in Patients Suffering From Cardiogenic Shock Complicating Myocardial Infarction

Abstract

Hypothesis: Elevated glucose levels on admission are common in patients with acute coronary syndrome (ACS) and have been shown to be a strong predictor of adverse outcome in both diabetic and non-diabetic patients. Methods: The purpose of the study was to assess the impact of admission glucose levels on hospital mortality in patients with infarction related cardiogenic shock. Blood glucose levels were measured from first available routine blood specimens up to 96 hours. Results: We identified 40 patients with myocardial infarction related cardiogenic shock treated at our university hospital. 45 % of the population had an admission glucose level <6 mmol/L, 15 % had levels from 6 mmol/L up to 11 mmol/L and 40% above 11 mmol/L. In-hospital mortality rate was higher in patients with increased admission glucose levels (<6, 6-11, and ≥11mmol/L: 27,8 %, 66,7 % and 62,5 % respectively, p <0.001). Similarly, significant mortality rate differences were observed in patient subgroups stratified by admission glucose level, presence of diabetes mellitus and cardiogenic shock. Additionally, a reduction of elevated blood glucose levels within six hours to near-normal values resulted in a favorable outcome (reduction within 6 hours vs. not within 6 hours: 25 % vs. 45 %, p<0.05). Interestingly Predictors of in-hospital mortality were age, admission glucose levels, diabetes mellitus, and renal failure. Conclusions: Blood glucose level on admission is a strong predictor of in-hospital mortality in patients with infarction related cardiogenic shock. Impact of admission glucose level on mortality is independent from clinically manifested diabetes and cardiogenic shock presence. Further analysis showed better survival in patients whose elevated blood glucose levels were reduced within 6 hours to normal or near-normal ranges.