Glycemia and inflammatory markers in acute coronary syndrome: association with late post-hospital outcomes.
BACKGROUND
Glycemia and inflammatory markers were associated with clinical outcomes in patients with acute coronary syndrome (ACS).


OBJECTIVE
To evaluate the role of glycemia and inflammatory markers as predictors of late cardiovascular outcomes after ACS.


METHODS
One hundred and ninety-nine ACS patients of a Coronary Care Unit were included, from March to November 2002. They were reassessed clinically after approximately 3 years. Clinical variables, glycemia, CRP and fibrinogen were evaluated as event and mortality predictors. Statistical analyses included Cox multivariate analysis and survival curves (Kaplan-Meier).


RESULTS
At admission, 16.7% had normal glycemia. After 3 years, this proportion increased to 55.2%; the 40.6% who belonged to the borderline category decreased to 27.1%; the 42.7% with elevated glycemia decreased to 17.7%. Glycemia was not associated with the development of major cardiovascular events (MACE) and mortality at follow-up ( approximately 3 years). Considering MACE, CRP (p<0.001), but not fibrinogen, was predictive in bivariate analysis. Regarding mortality, both fibrinogen (p=0.020) and CRP (p=0.008) were predictive in bivariate analysis.


CONCLUSIONS
Glycemia was not associated with late mortality after ACS, but inflammatory markers were, suggesting that these are more sensitive markers to predict events in long-term. Moreover, glucose intolerance prevalence is lower in the follow-up after the ACS episode.
Maciel
Patrícia Tolledo
PT
Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, Brazil.
Pellanda
Lucia Campos
LC
Portal
Vera Lucia
VL
Schaan
Beatriz D'Agord
BD
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D015415:Biomarkers; D001786:Blood Glucose; D005340:Fibrinogen; D002097:C-Reactive Protein