title: Association between admission hypoglycaemia and in-hospital and 3-year mortality in older patients with acute myocardial infarction.
abstract: OBJECTIVE
  To assess the association between fasting plasma glucose (FPG) levels on admission and mortality in older patients with acute myocardial infarction (AMI), and compare the effects of FPG levels on outcomes in the context of contemporary treatments, including drug treatment, percutaneous coronary intervention and coronary artery bypass grafting.
  
  
  METHODS
  From April 2004 to October 2006, 1854 older (age > or =65 years) patients with AMI were enrolled in the Beijing Elderly Acute Myocardial Infarction Study (BEAMIS) consecutively. Patients were categorised into 4 groups: hypoglycaemia group (N=443, 23.9%), FPG< or =5 mmol/l; euglycaemia group (N=812, 43.8%), FPG> or = 5.1 to< or =7.0 mmol/l (5-7 mmol/l); mild hyperglycaemia group (N=308, 16.6%), FPG> or = 7.1 to< or =9.0 mmol/l (7-9 mmol/l); and severe hyperglycaemia group (N=291, 15.7%), FPG> or =9.1 mmol/l. The primary end point was in-hospital and 3-year all-cause mortality from the day of admission.
  
  
  RESULTS
  Compared with the euglycaemia group, hypoglycaemia or hyperglycaemia groups were all associated with higher in-hospital and 3-year all-cause mortality. There was a U-shaped relationship between admission FPG levels and short- and long-term all-cause mortality. This U-shaped relationship applied equally to subgroups in the context of contemporary treatments.
  
  
  CONCLUSIONS
  In older patients with AMI, increased as well as decreased admission FPG levels could predict higher in-hospital and 3-year mortality. There was a striking U-shaped relationship between admission FPG levels and short- and long-term mortality. An initial admission FPG level > or = 5.1 to< or =7.0 mmol/l may be desirable because it was associated with better clinical outcomes.
authors.affiliation: 12th Ward, Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Da-Yi
authors.initials: DY
authors.lastname: Hu
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Nie
authors.forename: Yu-Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
authors.forename: Xian
authors.initials: X
authors.lastname: Wang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000401:mortality; D007003:Hypoglycemia / Q000097:blood / Q000150:complications / Q000401:mortality*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000401:mortality*; D011379:Prognosis
chemical_list: D001786:Blood Glucose