Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention.
OBJECTIVE
Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events. We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients (> 65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction.


METHODS
We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ± 5.4). Patients were divided into two groups according to admission blood glucose levels. Group 1: low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose > 168 mg/dL.


RESULTS
In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P < 0.001). Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI < 3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P < 0.001).


CONCLUSIONS
Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality.
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Ahmet
A
Ekmekci
Department of Cardiology, Kadirli State Hospital, Toki Caddesi, 8075 Osmaniye, Turkey.
Mahmut
M
Uluganyan
Department of Geriatric, Istanbul University Medical Hospital, Vatan Cadddessi, 34000 Istanbul, Turkey.
Fatif
F
Tufan
Department of Cardiology, Bezmialem Vakif University Medical Hospital, Vatan Caddesi, 34000 Istanbul, Turkey.
Huseyin
H
Uyarel
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Gurkan
G
Karaca
Department of Cardiology, Bezmialem Vakif University Medical Hospital, Vatan Caddesi, 34000 Istanbul, Turkey.
Seref
S
Kul
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Barış
B
Gungor
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Gokhan
G
Ertas
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Betul
B
Erer
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Nurten
N
Sayar
Department of Cardiology, Bezmialem Vakif University Medical Hospital, Vatan Caddesi, 34000 Istanbul, Turkey.
Mehmet
M
Gul
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Tıbbiye Caddesi, 34000 Istanbul, Turkey.
Mehmet
M
Eren
Admission hyperglycemia; Elderly patients; In-hospital mortality; Long-term mortality; Major adverse cardiac events