Abstract
AimsAdmission hyperglycemia is associated with increased mortality and major adverse cardiac events (MACE) in patients with or without diabetes mellitus after acute myocardial infarction (AMI). However, effects of glycemic variability (GV) on outcomes of non-diabetes patients with AMI still remains unclear. The aim of this study is to compare the prognostic value of in-hospital GV with admission blood glucose (ABG) for 3-month MACE in non-diabetes patients with ST elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI).MethodsWe analyzed 256 non-diabetes patients with STEMI in study. The GV accessed by mean amplitude of glycemic excursions (MAGE) was calculated from blood glucose profiles of continuous glucose monitoring system (CGMS) during hospitalization. ABG was measured on admission. Main endpoints were 3-month MACE; secondary endpoints were GRACE scores and enzymatic infarct size. Predictive effects of MAGE and ABG on the MACE in patients were analyzed.ResultsIn all participants, MAGE level was associated with ABG level (r = 0.242, p < 0.001). Both elevated MAGE levels (p = 0.001) and elevated ABG (p = 0.046) were associated with incidences of short-term MACE. Patients with a higher MAGE level had a significantly higher cardiac mortality (5.8 vs. 0.6%, p = 0.017) and incidence of acute heart failure (12.8 vs. 2.4%, p = 0.001) during 3 months follow-up. In multivariable analysis, high MAGE level (HR 2.165, p = 0.023) was significantly associated with incidence of short-term MACE, but ABG (HR 1.632, p = 0.184) was not. The area under the receiver-operating characteristic curve for MAGE (0.690, p < 0.001) was superior to that for ABG (0.581, p = 0.076).ConclusionsTo compare with ABG, in-hospital GV may be a more important predictor of short-term MACE and mortality in non-diabetes patients with STEMI treated with PCI.
Highlights
Acute hyperglycemia on admission is common in nondiabetes patients with acute myocardial infarction (AMI), and is a risk factor for increased mortality and in-hospital adverse outcomes [1, 2]
We investigated the independent prognostic value of the in-hospital glycemic variability (GV) and admission blood glucose (ABG) levels in patients without known diabetes mellitus who underwent percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI)
Baseline characteristics During the study period, 265 patients were enrolled. 256 patients (96.6%) with complete data were included in the final analysis (9 patients were removed from study, 5 for failure of continuous glucose monitoring system (CGMS) monitoring and 4 for incomplete follow-up data)
Summary
Acute hyperglycemia on admission is common in nondiabetes patients with acute myocardial infarction (AMI), and is a risk factor for increased mortality and in-hospital adverse outcomes [1, 2]. It has shown that high admission blood glucose (ABG) levels are associated with increased mortality after AMI [3, 4]. Recent studies have shown that glycemic variability (GV) may be of prognostic value with regard to future cardiovascular events [5, 6]. Whether GV has the important prognostic significance of short-term major adverse cardiac events (MACE) in non-diabetes patients is unknown. We investigated the independent prognostic value of the in-hospital GV and ABG levels in patients without known diabetes mellitus who underwent percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
