In patients with acute myocardial infarction, the impact of hyperglycemia as a risk factor for mortality is not homogeneous across age-groups.
OBJECTIVE
To assess the impact of hyperglycemia in different age-groups of patients with acute myocardial infarction (AMI).


METHODS
A total of 2,027 patients with AMI were categorized into one of five age-groups: <50 years (n = 301), ≥50 and <60 (n = 477), ≥60 and <70 (n = 545), ≥70 and <80 (n = 495), and ≥80 years (n = 209). Hyperglycemia was defined as initial glucose ≥115 mg/dL.


RESULTS
The adjusted odds ratios for hyperglycemia predicting hospital mortality in groups 1-5 were, respectively, 7.57 (P = 0.004), 3.21 (P = 0.046), 3.50 (P = 0.003), 3.20 (P < 0.001), and 2.16 (P = 0.021). The adjusted P values for correlation between glucose level (as a continuous variable) and mortality were 0.007, <0.001, 0.043, <0.001, and 0.064. The areas under the ROC curves (AUCs) were 0.785, 0.709, 0.657, 0.648, and 0.613. The AUC in group 1 was significantly higher than those in groups 3-5.


CONCLUSIONS
The impact of hyperglycemia as a risk factor for hospital mortality in AMI is more pronounced in younger patients.
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. corjnicolau@incor.usp.br
José Carlos
JC
Nicolau
Carlos Vicente
CV
Serrano
Roberto Rocha
RR
Giraldez
Luciano Moreira
LM
Baracioli
Humberto Graner
HG
Moreira
Felipe
F
Lima
Marcelo
M
Franken
Roberto
R
Kalil
José Antonio Franchini
JA
Ramires
Robert P
RP
Giugliano
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012307:Risk Factors
D001786:Blood Glucose