title: [Markers for early detection of alterations in carbohydrate metabolism after acute myocardial infarction].
abstract: OBJECTIVE
  Undiagnosed abnormal glucose metabolism is often seen in patients admitted with acute myocardial infarction, although there is no consensus on which patients should be studied with a view to establishing an early diagnosis. The present study examines the potential of certain variables obtained upon admission to diagnose abnormal glucose metabolism.
  
  
  METHODS
  A prospective cohort study was carried out.
  
  
  METHODS
  The Intensive Care Unit of Arrixaca University Hospital (Murcia), Spain.
  
  
  METHODS
  A total of 138 patients admitted to the Intensive Care Unit with acute myocardial infarction and without known or de novo diabetes mellitus. After one year, oral glucose tolerance testing was performed.
  
  
  RESULTS
  Clinical and laboratory test parameters were recorded upon admission and one year after discharge. Additionally, after one year, oral glucose tolerance tests were made, and a study was made of the capacity of the variables obtained at admission to diagnose diabetes, based on the ROC curves and multivariate analysis.
  
  
  RESULTS
  Of the 138 patients, 112 (72.5%) had glucose metabolic alteration, including 16.7% with diabetes. HbA1c was independently associated with a diagnosis of diabetes (RR: 7.28, 95%CI 1.65 to 32.05, P = .009), and showed the largest area under the ROC curve for diabetes (0.81, 95%CI 0.69 to 0.92, P = .001).
  
  
  CONCLUSIONS
  In patients with acute myocardial infarction, HbA1c helps identify those individuals with abnormal glucose metabolism after one year. Thus, its determination in this group of patients could be used to identify those subjects requiring a more exhaustive study in order to establish an early diagnosis.
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: josehdegea@hotmail.com.
authors.forename: J H
authors.initials: JH
authors.lastname: de Gea-García
authors.affiliation: Servicio de Análisis Clínicos, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: L
authors.initials: L
authors.lastname: Benali
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: J
authors.initials: J
authors.lastname: Galcerá-Tomás
authors.affiliation: Unidad de Cuidados Intensivos, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
authors.forename: A
authors.initials: A
authors.lastname: Padilla-Serrano
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: E
authors.initials: E
authors.lastname: Andreu-Soler
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Santa Lucía, Cartagena, Murcia, España.
authors.forename: A
authors.initials: A
authors.lastname: Melgarejo-Moreno
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Santa Lucía, Cartagena, Murcia, España.
authors.forename: N
authors.initials: N
authors.lastname: Alonso-Fernández
mesh_terms: D000368:Aged; D050260:Carbohydrate Metabolism; D002318:Cardiovascular Diseases; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis* / Q000209:etiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000378:metabolism*; D011446:Prospective Studies
keywords: Diabetes mellitus; Hemoglobin A1c; Hemoglobina A1c; Infarto agudo de miocardio; Myocardial infarction; Oral glucose tolerance test; Sobrecarga oral de glucosa