[Effect of admission blood glucose levels on the short term mortality in patients with acute ST-segment elevation myocardial infarction].
OBJECTIVE
To evaluate the predictive value of different admission blood glucose levels for short-term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI).


METHODS
An observational analysis of 7446 Chinese STEMI patients from a global randomized controlled trials were recruited within 12 hours of symptom onset. According to the levels of admission glucose, these patients were divided into six groups, admission glucose < 4.50 mmol/L was defined as the hypoglycemia group; glucose of 4.5 - 5.5 mmol/L a control; 5.6 - 7.0 mmol/L, 7.1 - 8.5 mmol/L (mild hyperglycemia group) and 8.6 - 11.0 mmol/L (moderate hyperglycemia group); glucose > 11.0 mmol/L was the severe hyperglycemia group. The 30-day mortality was analyzed.


RESULTS
Compared with the glucose of 4.5 - 5.5 mmol/L group, thirty-day mortality increased in patients with hypoglycemia (10.2%, P < 0.05), mild and moderate hyperglycemia (9.2%, P = 0.01; 11.6%, P < 0.01, respectively) and severe hyperglycemia (18.6%, P < 0.01). The highest mortality occurred in the severe hyperglycemia group. Multivariate logistic regression analysis showed that, as compared with glucose of 4.5 - 5.5 mmol/L, the mild and the moderate hyperglycemia groups had a mortality increasing of 46% (OR 1.46, 95% CI 1.03 - 2.07, P = 0.01) and 58% fold (OR 1.58, 95% CI 1.13 - 2.22 P = 0.02) respectively; the severe hyperglycemia group had a risk of death of 2.26 folds (OR 2.26, 95% CI 1.62 - 3.14, P = 0.05). Mild, moderate and severe hyperglycemia were independent predictors of 30-day mortality.


CONCLUSIONS
The 30-day mortality was higher in STEMI patients with mild, moderate and severe hyperglycemia at admission. Admission blood glucose level is an important factor associated with a short-term.
Yang
Yan-Min
YM
Cardiovascular Institute and Fu Wai Heart Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Liu
Yao
Y
Zhu
Jun
J
Tan
Hui-Qiong
HQ
Liang
Yan
Y
Li
Ying
Y
Li
Jian-Dong
JD
Zhang
Yan
Y
Liu
Li-Sheng
LS
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D007003:Hypoglycemia / Q000150:complications; D007297:Inpatients; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D001786:Blood Glucose