Abstract
Diabetes is associated with increased cardiovascular morbidity and mortality. We studied the relationship between hyperglycaemia, troponin I concentrations and one-year mortality in 498 subjects admitted to hospital with an acute coronary syndrome. The proportion of deaths was higher in those with hyperglycaemia (random glucose > 11.1 mmol/L) compared to those without (27% and 12%, respectively, Chi-squared test = 9.84, p=0.002). There was a difference in troponin I concentration on admission between those patients who were alive and dead (median and interquartile range 0.14 [0 to 3.90] and 2.98 [0.23 to 18.53] respectively, p<0.001) and the risk of death was elevated in those with a myocardial infarction compared to those without (relative risk = 1.85, 95% confidence intervals 1.55 to 2.21). Despite adherence to guidelines for the management of acute coronary syndromes, the presence of hyperglycaemia confers a significant long-term mortality disadvantage.
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