Abstract 573: Relation between Admission Plasma Glucose and In-Hospital Mortality is Different between Diabetic and Non-Diabetic Patients with Acute Myocardial Infarction

Abstract

It has been well demonstrated that acute hyperglycemia is associated with high mortality after acute myocardial infarction (AMI). However, optimal plasma glucose (PG) level is not known. The relation between PG and mortality may be different between diabetic and non-diabetic patients. This study consisted of 3,750 patients who were admitted to the 35 hospitals participating to the Japanese Acute Coronary Syndrome Study (JACSS) group within 48 hours after the onset of AMI. PG was measured at the time of hospital admission. In non-diabetic patients, there was a linear relation between PG and in-hospital mortality. Non-diabetic patients with PG <6 mmol/L had the lowest mortality (2.5%). As PG increased by 1 mmol/L, mortality increased by 17% (13%–21%, p<0.001). However, in diabetic patients, there was a U-shape relation between PG and mortality (Figure ). Diabetic patients with PG 9–10 mmol/L had the lowest mortality (1.9%); both diabetic patients with PG <7 mmol/L (9.4%, p=0.009) and those with PG ≥11 mmol/L (9.1%, p<0.001) had significantly higher mortality than those with PG 7–11 mmol/L (3.2%). Diabetic patients with PG 9–10 mmol/L had the lowest mortality, whereas lower PG was better in non-diabetic patients. Optimal PG level may be different between diabetic and non-diabetic patients with AMI.