TY - JOUR
T1 - Has hyperglycemia a different prognostic role in STEMI patients with or without diabetes?
AU - Demarchi, Andrea
AU - Cornara, Stefano
AU - Somaschini, Alberto
AU - Fortuni, Federico
AU - Mandurino-Mirizzi, Alessandro
AU - Crimi, Gabriele
AU - Ferlini, Marco
AU - Gnecchi, Massimiliano
AU - De Servi, Stefano
AU - Visconti, Luigi Oltrona
AU - De Ferrari, Gaetano Maria
N1 - Funding Information:
All authors report no disclosures related to this work. Part of these data were presented at the Acute Cardiovascular Care Congress in Milan, March (2018).
Publisher Copyright:
© 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/8
Y1 - 2021/2/8
N2 - Background and aims: Hyperglycemia at hospital admission is a common finding in patients with STEMI. However, whether elevated acute glycemia in these patients may have a direct impact on worsening prognosis or is just a marker of a greater neurohormonal activation in response to the infarction is still unsettled. We sought to investigate the prognostic impact of hyperglycemia at hospital admission in patients undergoing primary PCI (pPCI) for STEMI, and the influence of the presence of diabetes mellitus (DM) on its prognostic impact. Methods: and Results, We enrolled 2958 consecutive STEMI patients treated by pPCI. Hyperglycemia was defined as plasma glucose >198 mg/dL (or >11 mmol/L). Patients with hyperglycemia showed a greater risk-profile; they also experienced a higher mortality both at univariable (17.6% vs 5.2%, p < 0.001) and multivariable (HR 1.9, 95%IC 1.5–2.9, p = 0.001) analysis. However, after stratification for DM presence, hyperglycemia resulted as an independent predictor of mortality only in patients without DM (HR 2, 95%IC 1.2–3.4, p = 0.01). Conclusion: Hyperglycemia in the setting of myocardial infarction treated with primary PCI in an independent predictor of all-cause mortality in patients without diabetes; in patients with diabetes, its prognostic impact seems attenuated.
AB - Background and aims: Hyperglycemia at hospital admission is a common finding in patients with STEMI. However, whether elevated acute glycemia in these patients may have a direct impact on worsening prognosis or is just a marker of a greater neurohormonal activation in response to the infarction is still unsettled. We sought to investigate the prognostic impact of hyperglycemia at hospital admission in patients undergoing primary PCI (pPCI) for STEMI, and the influence of the presence of diabetes mellitus (DM) on its prognostic impact. Methods: and Results, We enrolled 2958 consecutive STEMI patients treated by pPCI. Hyperglycemia was defined as plasma glucose >198 mg/dL (or >11 mmol/L). Patients with hyperglycemia showed a greater risk-profile; they also experienced a higher mortality both at univariable (17.6% vs 5.2%, p < 0.001) and multivariable (HR 1.9, 95%IC 1.5–2.9, p = 0.001) analysis. However, after stratification for DM presence, hyperglycemia resulted as an independent predictor of mortality only in patients without DM (HR 2, 95%IC 1.2–3.4, p = 0.01). Conclusion: Hyperglycemia in the setting of myocardial infarction treated with primary PCI in an independent predictor of all-cause mortality in patients without diabetes; in patients with diabetes, its prognostic impact seems attenuated.
KW - Acute hyperglycemia
KW - Diabetes mellitus
KW - Glucidic pre-conditioning
KW - Inflammation
KW - Myocardial infarction
KW - Primary PCI
KW - Prognosis
KW - STEMI
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U2 - 10.1016/j.numecd.2020.09.005
DO - 10.1016/j.numecd.2020.09.005
M3 - Article
C2 - 33223396
AN - SCOPUS:85096585092
VL - 31
SP - 528
EP - 531
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
SN - 0939-4753
IS - 2
ER -