Abstract
Objective To evaluate the effect of admission hyperglycemia on the short-term prognosis of patients with non-ST elevation acute coronary syndrome (NSTE-ACS) without diabetes mellitus. Methods The clinical data of 498 patients with NSTE-ACS admitted to the Department of Cardiology of the First Affiliated Hospital of Henan University of Science and Technology between March 2018 and November 2020 were analyzed. Based on the blood glucose (BG) level at admission, patients were divided into three groups: A (BG < 7.8 mmol/L), B (7.8 mmol/L ≤ BG < 11.1 mmol/L), and C (BG ≥ 11.1 mmol/L). The clinical data of the three groups were compared. Results There was no significant difference between the three groups in terms of age, sex, hypertension, hyperlipidemia, smoking, and history of myocardial infarction (p > 0.05). However, there were significant differences in the incidences of multivessel disease, renal insufficiency, pump failure, and emergency percutaneous coronary intervention, and levels of high-sensitivity C-reactive protein, cardiac troponin T, and creatine kinase isoenzyme MB among the three groups (p < 0.05 for all). The incidences of severe pump failure, malignant arrhythmias, and death were significantly higher in groups B and C compared to group A (p < 0.05). Additionally, the incidences of severe pump failure, malignant arrhythmias, and death were significantly higher in group C compared to group B (p < 0.05). Multivariate logistic regression analysis showed that hyperglycemia, renal insufficiency, Killip grade III/IV, and age were risk factors of in-hospital death. Conclusion Hyperglycemia at admission is a risk factor for adverse in-hospital clinical outcomes in patients with NSTE-ACS.
Highlights
Diabetes is an important independent risk factor for coronary atherosclerosis
Previous studies showed that admission hyperglycemia was an independent risk factor for poor prognosis of acute coronary syndrome (ACS) patients, irrespective of whether or not they had diabetes [9, 10]
Pasquale first showed that hyperglycemia was associated with adverse outcomes and increased risk of restenosis in ST-elevation myocardial infarction patients without diabetes mellitus [11]
Summary
Diabetes is an important independent risk factor for coronary atherosclerosis. Many previous studies have confirmed that hyperglycemia at admission is common in patients with acute coronary syndrome (ACS), and it is a risk factor for inhospital death and complications [1,2,3,4]. Previous epidemiological studies showed that 25–50% of ACS patients had elevated blood glucose (BG) level at admission. Recent studies suggest that the effects of hyperglycemia on the prognosis of ACS differ between diagnosed and undiagnosed diabetes. Hyperglycemia is a stronger predictor of adverse events in ACS patients without known diabetes than those with history of diabetes [5, 6]. The aim of this study was to investigate the effect of admission hyperglycemia on the short-term prognosis in patients with the non-ST elevation ACS (NSTE-ACS) without diabetes
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