title: The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively.
abstract: BACKGROUND
  Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear.
  
  
  OBJECTIVE
  To assess the incidence and impact of GA on clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI).
  
  
  METHODS
  A single-center, prospective registry encompassed 2733 consecutive AMI subjects treated with PCI. In all in-hospital survivors (n = 2527, 92.5%) without the history of DM diagnosed before or during index hospitalization standard oral glucose tolerance test (OGTT) was performed during stable condition before hospital discharge and interpreted according to WHO criteria. The mean follow-up period was 37.5 months.
  
  
  RESULTS
  The incidence of GA was as follows: impaired fasting glycaemia - IFG (n = 376, 15%); impaired glucose tolerance - IGT (n = 560, 22%); DM (n = 425, 17%); new onset DM (n = 384, 15%); and normal glucose tolerance - NGT (n = 782, 31%). During the long-term follow-up, death rate events for previously known DM, new onset DM and IGT were significantly more frequent than those for IFG and NGT (12.3; 9.6 and 9.4 vs. 5.6 and 6.4%, respectively, P < 0.05). The strongest and common independent predictors of death in GA patients were glomerular filtration rate < 60 ml/min/1,73 m^2 (HR 2.0 and 2.8) and left ventricle ejection fraction < 35% (HR 2.5 and 1.8, all P < 0.05) respectively.
  
  
  CONCLUSIONS
  Glucose abnormalities are very common in AMI patients. DM, new onset DM and IGT increase remote mortality. Impaired glucose tolerance bears similar long-term prognosis as diabetes.
authors: Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases, ul, Szpitalna 2, 41-800, Zabrze, Poland. m.i.c.h.a.l@wp.pl
authors: Michal
authors: M
authors: Mazurek
authors: Jacek
authors: J
authors: Kowalczyk
authors: Radoslaw
authors: R
authors: Lenarczyk
authors: Teresa
authors: T
authors: Zielinska
authors: Agnieszka
authors: A
authors: Sedkowska
authors: Patrycja
authors: P
authors: Pruszkowska-Skrzep
authors: Andrzej
authors: A
authors: Swiatkowski
authors: Beata
authors: B
authors: Sredniawa
authors: Oskar
authors: O
authors: Kowalski
authors: Lech
authors: L
authors: Polonski
authors: Krzysztof
authors: K
authors: Strojek
authors: Zbigniew
authors: Z
authors: Kalarus
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D016009:Chi-Square Distribution; D005260:Female; D005919:Glomerular Filtration Rate; D044882:Glucose Metabolism Disorders / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D001786:Blood Glucose