Impaired fasting glucose and cardiogenic shock in patients with acute myocardial infarction.
OBJECTIVE
In-hospital outcome after acute myocardial infarction (MI) has not yet been evaluated with regard to the new category of Impaired Fasting Glucose level (IFG) patients defined by the American Diabetes Association (ADA).


METHODS
Nine hundred and ninety-nine patients with acute MI from the RICO survey were included in the study. Fasting blood glucose was measured after admission. Patients were grouped according to ADA definitions: Diabetes Mellitus (DM) (FG >/=7mmol/l or personal history of DM); IFG (FG 6.1 to 7mmol/l); NFG (normal FG <6.1mmol/l).


RESULTS
Three hundred and eighty-one patients (38%) had DM, 145 (15%) IFG and 473 (47%) NFG. Mortality in the IFG group was twice that of the NFG group (8% vs 4%, P=0.049). A significant increase in cardiogenic shock (12% vs 6%, P=0.011) and ventricular arrhythmia (15% vs 9%, P=0.035) was observed in the IFG vs NFG group. IFG, after adjustment for confounding factors (age, sex, anterior location, and LVEF), was a strong independent predictive factor for cardiogenic shock (P=0.005).


CONCLUSIONS
MI patients with IFG had an overall worse outcome, characterized by a higher risk of developing cardiogenic shock during their hospital stay.
Service de Cardiologie, CHU Bocage, Dijon, France. marianne.zeller@u-bourgogne.fr
Marianne
M
Zeller
Yves
Y
Cottin
Marie-Claude
MC
Brindisi
Gilles
G
Dentan
Yves
Y
Laurent
Luc
L
Janin-Manificat
Isabelle
I
L'Huillier
Jean-Claude
JC
Beer
Claude
C
Touzery
Hamid
H
Makki
Bruno
B
Verges
Jean-Eric
JE
Wolf
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005215:Fasting / Q000502:physiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012770:Shock, Cardiogenic / Q000097:blood* / Q000401:mortality
D001786:Blood Glucose