Impact of fasting glycemia on short-term prognosis after acute myocardial infarction.
OBJECTIVE
The prognosis of patients with acute myocardial infarction (MI), according to the new criteria for impaired fasting glucose (IFG) (FG 100-126 mg/dl), has not been evaluated.


METHODS
A total of 2353 patients with acute MI and surviving at d 5 after admission were analyzed for short-term morbidity and mortality. FG was obtained at d 4 and 5. Patients were classified as diabetes mellitus (known diabetes or FG > or = 126 mg/dl), high IFG (110 < or = FG < 126 mg/dl), low IFG (100 < or = FG < 110 mg/dl), and normal fasting glucose (NFG) (FG < 100 mg/dl).


RESULTS
Among the 2353 patients, 968 (41%) had diabetes mellitus, 262 (11%) had high IFG, 332 (14%) had low IFG, and 791 (34%) had NFG. Compared with NFG patients, 30-d cardiovascular mortality was increased in high but not low IFG subjects. In-hospital heart failure was increased in high IFG subjects (42 vs. 20% for NFG, P < 0.0001) but not low IFG subjects (21 vs. 20%). High IFG, but not low IFG, was an independent factor associated with 30-d cardiovascular mortality [odds ratio 2.33 (1.55-3.47)] and in-hospital heart failure [odds ratio 1.70 (1.36-2.07)]. The optimal threshold levels of FG on the receiver-operating characteristic curves were 114 and 112 mg/dl to predict mortality and in-hospital heart failure, respectively.


CONCLUSIONS
The present study, based on a nonselected cohort of MI patients, underscores the high prevalence of IFG (25%) and highlights the clinical relevance of 110 mg/dl, but not 100 mg/dl, as a cutoff value to define the risk for worse outcome.
Vergès
Bruno
B
Service d'Endocrinologie, Centre Hospitalier Universitaire Bocage, Bd Mal de Lattre de Tassigny, Dijon, France. bruno.verges@chu-dijon.fr
Zeller
Marianne
M
Dentan
Gilles
G
Beer
Jean-Claude
JC
Laurent
Yves
Y
Janin-Manificat
Luc
L
Makki
Hamid
H
Wolf
Jean Eric
JE
Cottin
Yves
Y
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000378:metabolism / Q000401:mortality; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000378:metabolism* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity
D001786:Blood Glucose