title: Diabetes mellitus and glucose as predictors of mortality in primary coronary percutaneous intervention.
abstract: BACKGROUND
  Diabetes mellitus and admission blood glucose are important risk factors for mortality in ST segment elevation myocardial infarction patients, but their relative and individual role remains on debate.
  
  
  OBJECTIVE
  To analyze the influence of diabetes mellitus and admission blood glucose on the mortality of ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention.
  
  
  METHODS
  Prospective cohort study including every ST segment elevation myocardial infarction patient submitted to primary coronary percutaneous intervention in a tertiary cardiology center from December 2010 to May 2012. We collected clinical, angiographic and laboratory data during hospital stay, and performed a clinical follow-up 30 days after the ST segment elevation myocardial infarction. We adjusted the multivariate analysis of the studied risk factors using the variables from the GRACE score.
  
  
  RESULTS
  Among the 740 patients included, reported diabetes mellitus prevalence was 18%. On the univariate analysis, both diabetes mellitus and admission blood glucose were predictors of death in 30 days. However, after adjusting for potential confounders in the multivariate analysis, the diabetes mellitus relative risk was no longer significant (relative risk: 2.41, 95% confidence interval: 0.76 - 7.59; p-value: 0.13), whereas admission blood glucose remained and independent predictor of death in 30 days (relative risk: 1.05, 95% confidence interval: 1.02 - 1.09; p-value ≤ 0.01).
  
  
  CONCLUSIONS
  In ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention, the admission blood glucose was a more accurate and robust independent predictor of death than the previous diagnosis of diabetes. This reinforces the important role of inflammation on the outcomes of this group of patients.
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Renato Budzyn
authors.initials: RB
authors.lastname: David
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Eduardo Dytz
authors.initials: ED
authors.lastname: Almeida
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Larissa Vargas
authors.initials: LV
authors.lastname: Cruz
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Juliana Cañedo
authors.initials: JC
authors.lastname: Sebben
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Ivan Petry
authors.initials: IP
authors.lastname: Feijó
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Karine Elisa Schwarzer
authors.initials: KE
authors.lastname: Schmidt
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Luísa Martins
authors.initials: LM
authors.lastname: Avena
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Carlos Antonio Mascia
authors.initials: CA
authors.lastname: Gottschall
authors.affiliation: Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
authors.forename: Alexandre Schaan de
authors.initials: AS
authors.lastname: Quadros
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D048909:Diabetes Complications / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose