The impact of plasma glucose levels on in-hospital and long-term mortality in non-diabetic patients with ST-segment elevation myocardial infarction patients

Abstract

Objective: Increased admission plasma glucose can be seen in the acute phase of acute coronary syndromes (ACS). Hence, we performed a retrospective study to evaluate the admission plasma glucose concentration in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) and who had no previous diagnosis of Diabetes Mellitus (DM).Method: This retrospective study included 2504 consecutive confirmed STEMI patients treated with pPCI. The patients were divided into quantiles according to the admission glucose levels. Quantile I: 94 ± 7 mg/dL (n= 626), quantile II: 112 ± 5 mg/dL (n = 626), quantile III: 131 ± 6 mg/dL (n= 626), quantile IV: 184 ± 46 mg/dL (n= 626).Results: Patients with higher plasma glucose (Q4) had 6.6 times higher in-hospital all-cause mortality rates (95% CI: 3.95–9.30) and 3.12 times higher (95% CI: 2.2–4.4) long-term all-cause mortality rates than patients with lower plasma glucose (Q1–Q3), who had lower rates and were used as the reference. This significant relationship remained even after adjustment for all confounders. Conclusion: Even though glucose-lowering therapy is recommended in ACS patients with glucose levels >180 mg/dL, our results showed that high plasma glucose, even lower than 180 mg/dL, could predict in-hospital and long-term mortality.