Effects of glucose abnormalities on in-hospital outcome after coronary intervention for acute myocardial infarction.
BACKGROUND
The effects of glucose abnormalities on outcomes after percutaneous coronary intervention (PCI) remain unclear. We examined the association between glucose abnormalities and in-hospital outcome in patients undergoing PCI for acute myocardial infarction (AMI).


RESULTS
A total of 849 patients with AMI who were admitted within 12 h after symptom onset and underwent emergency PCI were classified according to the presence or absence of admission hyperglycemia, defined as a blood glucose level on admission of >11 mmol/L and whether they had a history of diabetes mellitus: group 1 (n = 504), non-diabetic patients without admission hyperglycemia; group 2 (n = 111), diabetic patients without admission hyperglycemia; group 3 (n = 87), non-diabetic patients with admission hyperglycemia; and group 4 (n = 147), diabetic patients with admission hyperglycemia. Among groups 1, 2, 3 and 4, in-hospital mortality was 2.6, 2.7, 11.5 and 8.8%, respectively (p < 0.01). Multivariate analysis showed that compared with group 1 patients, the odds ratio (95%confidence interval) for in-hospital mortality among those in groups 2, 3, and 4 were 0.80 (0.24-2.60, p = 0.708), 2.29 (1.10-5.49, p = 0.039), and 2.14 (1.14-4.69, p = 0.048), respectively.


CONCLUSIONS
In-patients undergoing PCI for AMI, admission hyperglycemia, irrespective of the presence or absence of diabetes, is associated with increased in-hospital mortality, whereas diabetes without admission hyperglycemia is not.
Kosuge
Masami
M
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Kojima
Sunao
S
Sakamoto
Tomohiro
T
Matsui
Kunihiko
K
Ishihara
Masaharu
M
Asada
Yujiro
Y
Tei
Chuwa
C
Miyazaki
Shunichi
S
Sonoda
Masahiro
M
Tsuchihashi
Kazufumi
K
Yamagishi
Masakazu
M
Ikeda
Yoshihiko
Y
Shirai
Mutsunori
M
Hiraoka
Hisatoyo
H
Inoue
Takeshi
T
Saito
Fumio
F
Ogawa
Hisao
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000628:therapy; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome