The association between hyperglycaemia and elevated troponin levels on mortality in acute coronary syndromes.
Diabetes is associated with increased cardiovascular morbidity and mortality. We studied the relationship between hyperglycaemia, troponin I concentrations and one-year mortality in 498 subjects admitted to hospital with an acute coronary syndrome. The proportion of deaths was higher in those with hyperglycaemia (random glucose > 11.1 mmol/L) compared to those without (27% and 12%, respectively, Chi-squared test = 9.84, p=0.002). There was a difference in troponin I concentration on admission between those patients who were alive and dead (median and interquartile range 0.14 [0 to 3.90] and 2.98 [0.23 to 18.53] respectively, p<0.001) and the risk of death was elevated in those with a myocardial infarction compared to those without (relative risk = 1.85, 95% confidence intervals 1.55 to 2.21). Despite adherence to guidelines for the management of acute coronary syndromes, the presence of hyperglycaemia confers a significant long-term mortality disadvantage.
Gale
Christopher P
CP
Academic Unit of Cardiovascular Medicine, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK. medcpg@medphysics.leeds.ac.uk
Kashinath
Chetan
C
Brooksby
Paul
P
D000208:Acute Disease; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000401:mortality; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*
D001786:Blood Glucose; D019210:Troponin I