title: Age-related differences in glucose abnormalities in women with ST-elevation myocardial infarction submitted to percutaneous coronary intervention: a single-center experience.
abstract: No datum is so far available on the relation between age and the acute glucose response to stress in women with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).We evaluated the age-related differences in the acute glucose response in 373 STEMI women submitted to PCI. The oldest women, when compared to the other age subgroups, showed the higher admission and peak glycemia (P < 0.001 and P < 0.001, respectively) in the lack of differences in insulin, C-peptide, hemoglobin-glycated values and discharge glycemia values. At logistic regression analysis, the following variables were independent predictors of in-Intensive Cardiac Care Unit mortality: age (1-year step) [odds ratio 1.09, 96% confidence interval (CI) 1.04-1.15, P = 0.001], admission glycemia (1g/l step) (odds ratio 2.05, 96% CI 1.35-3.12, P < 0.001). At Cox regression analysis the following variables were associated with 1-year mortality (when adjusted for discharge glycemia): age (1-year step) (hazard ratio 1.13, 95% CI 1.04-1.22, P = 0.005), estimated glomerular filtration rate (1 g/l step) (hazard ratio 0.93, 95% CI 0.90-0.96, P < 0.001).Age affects the acute glucose response to myocardial injury since older women showed the higher admission glucose values and the poorer in-hospital glucose control, in the lack of differences of insulin-resistance incidence. Glucose values were independent predictors of in-hospital mortality, but were not related to long-term survival.
authors.affiliation: Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: D'Alfonso
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.forename: Paola
authors.initials: P
authors.lastname: Attanà
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology*; D007333:Insulin Resistance / Q000502:physiology; D007362:Intensive Care Units; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis
chemical_list: D001786:Blood Glucose