Impact of newly diagnosed abnormal glucose tolerance on long-term prognosis in patients with acute myocardial infarction.
BACKGROUND
Newly-diagnosed diabetes mellitus (DM) and impaired glucose tolerance are common among patients with acute myocardial infarction (AMI). However, its significance on long-term clinical outcomes in those patients remains unclear. The present study was designed to determine whether such abnormalities after AMI affect long-term clinical outcomes.


RESULTS
Two-hundred and seventy-five AMI patients were prospectively enrolled. Eighty-five had diagnosed DM, while the other 190 did not. According to oral glucose tolerance tests at discharge, non-DM patients were divided into 2 groups: 78 patients with normal glucose tolerance and 112 patients with abnormal glucose tolerance. Patients were followed until they reached the primary endpoint: cardiovascular death or unplanned hospitalization due to major adverse cardiovascular events. The median follow-up period was 5.3 years. Kaplan-Meier survival curves for the abnormal glucose tolerance group were poorer than for normal glucose tolerance, and were equivalent to the pre-diagnosed DM group in prognosis (p<0.0005). Glucometabolic status was the strongest predictor for future cardiovascular events (hazard ratio to normal glucose tolerance; 2.65; confidence interval: 1.37-5.15; p=0.004 in abnormal glucose tolerance and 3.27:1.68-6.38; p=0.0005 in DM).


CONCLUSIONS
Abnormal glucose tolerance in patients with AMI is a major risk factor for future cardiovascular events and may critically distinguish high-risk individuals.
Tamita
Koichi
K
Department of Cardiovascular Medicine, Kobe General Hospital, 4-6 Minatojima-nakamachi, Chuo-ku, Kobe 650-0046, Japan. k-tamita@kcgh.gr.jp
Katayama
Minako
M
Takagi
Tsutomu
T
Akasaka
Takashi
T
Yamamuro
Atsushi
A
Kaji
Shuichiro
S
Morioka
Shigefumi
S
Kihara
Yasuki
Y
D000208:Acute Disease; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003643:Death; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose