Fasting blood sugar level: a determinant for in-hospital outcome in patients with first myocardial infarction and without glucose intolerance.
The body responds to stress, e.g. during infections or acute illnesses, by a variety of neurohormonal mechanisms. Some of these physiological responses sometimes lead to an elevation of the blood sugar level (BSL). BSL is a biochemical parameter which is readily and rapidly assayed. The aim of our study was to determine whether the glycaemic state of patients with their first myocardial infarction and without previous glucose intolerance was of predictive value for the type of outcome during the in-hospital and post-hospitalisation periods. We also delineated the factors which determined subsequent glucose tolerance in this group of patients. Forty-four consecutive patients were studied and those with complicated in-hospital outcome had a significantly higher mean BSL at admission (ABSL) and fasting BSL (FBSL). FBSL was shown to be a predictor for in-hospital outcome. The odds ratio for a complicated in-hospital outcome was 3.3 times for patients with a FBSL of greater than 6.7 mmol/l (120 mg/dl) than those without (p = 0.0175). We could not identify a predictor for an adverse outcome in the post-hospitalisation period. Oral glucose tolerance test was performed on twenty-seven patients at least six weeks after the infarction. Twelve were normal and fifteen were abnormal (six were diabetic and nine had impaired glucose tolerance). The odds ratio for patients with glycosylated haemoglobin level (HbAlc) between 7.5 and 9.5% was 2.19 higher than those less than 7.5% (p = 0.049). In conclusion, the FBSL is a determinant for the outcome for these patients during the in-hospital and not the post-hospitalisation period.(ABSTRACT TRUNCATED AT 250 WORDS)
Mak
K H
KH
Department of Medicine, Alexandra Hospital.
Mah
P K
PK
Tey
B H
BH
Sin
F L
FL
Chia
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012846:Singapore / Q000453:epidemiology; D016896:Treatment Outcome
D001786:Blood Glucose