title: Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease.
abstract: OBJECTIVE
  To assess the association between fasting plasma glucose (FPG) and all-cause mortality across the spectrum of coronary artery disease (CAD).
  
  
  METHODS
  The study included 18,999 patients during a study period of April 1, 2004, through October 31, 2010. The primary end points were in-hospital and follow-up all-cause mortality. According to the quartiles of FPG levels, patients were categorized into 4 groups: quartile 1, less than 5.1 mmol/L; quartile 2, 5.1 to less than 5.9 mmol/L; quartile 3, 5.9 to less than 7.5 mmol/L; and quartile 4, 7.5 mmol/L or greater. The conversion factor for units of plasma glucose is 1.00 mmol/L equals 18 mg/dL. Presented as mg/dL, the 4 quartile ranges of plasma glucose concentrations used in our data analysis are ≤90.0 mg/dL, 90.1-106.0 mg/dL, 106.1 mg/dL-135.0 mg/dL and ≥135.1 mg/dL. Quartile 1 was recognized as the lower glycemic group, quartiles 2 and 3 as the normoglycemic groups, and quartile 4 as the higher glycemic group.
  
  
  RESULTS
  In patients with acute myocardial infarction, all-cause mortality for the dysglycemic groups was higher than for the normoglycemic groups: in-hospital mortality for quartiles 1, 2, 3, and 4 was 1.0%, 0.9%, 0.2%, and 1.5%, respectively (P=.001); follow-up mortality for quartiles 1, 2, 3, and 4 was 1.7%, 0.9%, 0.3%, and 1.8%, respectively (P<.001). In patients with stable CAD, no significant differences in mortality were found among groups. However, in patients with unstable angina pectoris, the normoglycemic groups had lower follow-up mortality and roughly equal in-hospital mortality compared with the dysglycemic groups. After adjusting for confounding factors, this observation persisted.
  
  
  CONCLUSIONS
  The association between lower FPG level and mortality differed across the spectrum of CAD. In patients with acute myocardial infarction, there was a U-shaped relationship. In patients with stable CAD or unstable angina pectoris, mildly to moderately decreasing FPG level was associated with neither higher nor lower all-cause mortality.
authors.affiliation: 12th Ward, Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, 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-Fang
authors.initials: XF
authors.lastname: Tian
authors.forename: Guo-Zhong
authors.initials: GZ
authors.lastname: Pan
authors.forename: Yu-Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhen-Feng
authors.initials: ZF
authors.lastname: Guo
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Chen
authors.forename: Song-Tao
authors.initials: ST
authors.lastname: Gao
authors.forename: Jie
authors.initials: J
authors.lastname: Du
authors.forename: De-An
authors.initials: DA
authors.lastname: Jia
authors.forename: Zhe
authors.initials: Z
authors.lastname: Fang
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
authors.forename: Hong-Ya
authors.initials: HY
authors.lastname: Han
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Da-Yi
authors.initials: DY
authors.lastname: Hu
authors.forename: Yu-Yun
authors.initials: YY
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood / Q000401:mortality; D000789:Angina, Unstable / Q000097:blood / Q000401:mortality; D001786:Blood Glucose / Q000032:analysis*; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: ACC/AHA; ACS; AMI; American College of Cardiology/American Heart Association; BHMS; Beijing Heart and Metabolism Survey; CAD; CCS; Canadian Cardiovascular Society; DIGAMI; DM; Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction; FPG; HR; LDL-C; LVEF; PCI; SCAD; UAP; acute coronary syndrome; acute myocardial infarction; coronary artery disease; diabetes mellitus; fasting plasma glucose; hazard ratio; left ventricular ejection fraction; low-density lipoprotein cholesterol; percutaneous coronary intervention; stable coronary artery disease; unstable angina pectoris