title: Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era.
abstract: OBJECTIVE
  This study was undertaken to assess the association between acute hyperglycemia and inhospital outcome after acute myocardial infarction (AMI) in the percutaneous coronary intervention (PCI) era. We also assessed outcome of patients with a history of diabetes mellitus in the PCI era.
  
  
  METHODS
  Between January 2001 and December 2001, 1253 patients were admitted to the hospitals within 48 hours after the onset of AMI. Plasma glucose was measured at hospital admission. Acute hyperglycemia was defined as plasma glucose of > 11 mmol/L (198 mg/dL), regardless of the diabetic status. Primary PCI was performed in 898 (72%) patients.
  
  
  RESULTS
  The inhospital mortality rate was significantly higher in patients with acute hyperglycemia than in patients without (16% vs 6%, P < .001). However, there was no significant difference in mortality between diabetic and nondiabetic patients (8% vs 9%, P = .54). Acute hyperglycemia was associated with a higher inhospital mortality rate both in nondiabetic patients (24% vs 6%, P < .001) and in diabetic patients (10% vs 5%, P = .039). Acute hyperglycemia was associated with a higher incidence of no reflow during PCI (21% vs 12%, P < .001), but diabetes was not (14% vs 15%, P = .71).
  
  
  CONCLUSIONS
  Acute hyperglycemia, but not diabetes, was a predictor for inhospital mortality after AMI in the PCI era. No reflow occurred more frequently during PCI in patients with acute hyperglycemia, suggesting that microvascular dysfunction might have contributed to adverse outcome of these patients.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan. ishifami@fb3.so-net.ne.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Asada
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sonoda
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Tsuchihashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Mutsunori
authors.initials: M
authors.lastname: Shirai
authors.forename: Hisatoyo
authors.initials: H
authors.lastname: Hiraoka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Fumio
authors.initials: F
authors.lastname: Saito
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000401:mortality; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy*