title: Effect of abnormal fasting plasma glucose level on all-cause mortality in older patients with acute myocardial infarction: results from the Beijing Elderly Acute Myocardial Infarction Study (BEAMIS).
abstract: OBJECTIVE
  To assess whether the relationship between abnormal fasting plasma glucose (FPG) levels and patient outcomes holds for both older men and older women with acute myocardial infarction (AMI).
  
  
  METHODS
  From April 1, 2004, to October 31, 2006, a total of 2016 consecutive older patients (age ≥65 years) presenting with AMI were screened. Of these patients, 1854 were consecutively enrolled in the study. Patients were categorized into 4 groups: the hypoglycemic group (FPG, ≤90.0 mg/dL [to convert to mmol/L, multiply by 0.0555]; n=443, 23.9%), the euglycemic group (FPG, 90.1-126.0 mg/dL; n=812, 43.8%), the mildly hyperglycemic group (FPG, 126.1-162.0 mg/dL; n=308, 16.6%), and the severely hyperglycemic group (FPG, ≥162.1 mg/dL; n=291, 15.7%). The primary outcomes were rates of in-hospital and 3-year mortality.
  
  
  RESULTS
  Female patients were older and had a higher incidence of diabetes mellitus but lower rates of smoking and use of invasive therapy. Men tended to have a higher frequency of hypoglycemia, whereas women tended to have a higher frequency of hyperglycemia. No significant difference was found in in-hospital (10.9% vs 9.1%; P=.36) or 3-year (24.5% vs 24.5%; P=.99) mortality between male and female patients, and FPG-associated mortality did not vary significantly by sex.
  
  
  CONCLUSIONS
  An increased FPG level was associated with a relatively higher risk of in-hospital mortality in men but not in women. Nonetheless, increased and decreased FPG levels at admission could predict higher mortality rates regardless of sex. There was a striking U-shaped relationship between FPG levels and in-hospital and 3-year mortality. The effect of abnormal FPG level on outcomes among older patients with AMI did not vary significantly by sex.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital affiliated to Capital Medical University, An Ding Men Wai, Chao Yang District, Beijing, China.
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Nie
authors.forename: Yu-Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Jie
authors.initials: J
authors.lastname: Du
authors.forename: Da-Yi
authors.initials: DY
authors.lastname: Hu
authors.forename: De-An
authors.initials: DA
authors.lastname: Jia
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
authors.forename: Zhe
authors.initials: Z
authors.lastname: Fang
authors.forename: Hong-Ya
authors.initials: HY
authors.lastname: Han
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Liu
authors.forename: Zhen-Xian
authors.initials: ZX
authors.lastname: Yan
authors.forename: Jian-Long
authors.initials: JL
authors.lastname: Wang
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Shi
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000368:Aged; D001786:Blood Glucose; D002681:China / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D007003:Hypoglycemia / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D016016:Proportional Hazards Models; D017678:Sex Distribution
chemical_list: D001786:Blood Glucose