Abstract
Background: Acute myocardial infarction is known as an acute metabolic stress, but clinicians currently have limited guidance regarding the evaluation and management of hyperglycemia after revascularization. Methods and Results: We assessed the prognostic role of three different ranges of in-hospital peak glycemia (180 mg/dl) in 252 acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to percutaneous coronary intervention consecutively admitted to our intensive cardiac care unit (ICCU). Patients with highest peak glycemia showed the highest intra-ICCU mortality (7/44, 15.9%), which was significantly higher with respect to the other two subgroups (P=0.001 and 0.034, respectively). At backward stepwise logistic regression analysis, peak glycemia (odds ratio: 3.14; 95% confidence interval: 1.01-9.74, P=0.047) was an independent predictor of intra-ICCU mortality. Conclusion: In acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to mechanical revascularization, the poorer in-hospital glucose control was associated with higher mortality; peak glycemia greater than 180 mg/dl was associated with the highest mortality, whereas patients with peak glycemia comprised between 140 and 180 mg/dl exhibited intermediate mortality rates. According to our data during hospitalization intensivists should achieve glucose control values less than 140 mg/dl, as peak glycemia resulted in the independent predictor of intra-ICCU mortality.
| Original language | English |
|---|---|
| Pages (from-to) | 419-423 |
| Number of pages | 5 |
| Journal | European Journal of Cardiovascular Prevention and Rehabilitation |
| Volume | 17 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2010 |
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Keywords
- acute ST-segment elevation myocardial infarction
- in-hospital mortality
- nondiabetic
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Epidemiology
Cite this
In-hospital peak glycemia and prognosis in STEMI patients without earlier known diabetes. / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Picariello, Claudio; Gensini, Gian Franco.
In: European Journal of Cardiovascular Prevention and Rehabilitation, Vol. 17, No. 4, 08.2010, p. 419-423.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - In-hospital peak glycemia and prognosis in STEMI patients without earlier known diabetes
AU - Lazzeri, Chiara
AU - Valente, Serafina
AU - Chiostri, Marco
AU - Picariello, Claudio
AU - Gensini, Gian Franco
PY - 2010/8
Y1 - 2010/8
N2 - Background: Acute myocardial infarction is known as an acute metabolic stress, but clinicians currently have limited guidance regarding the evaluation and management of hyperglycemia after revascularization. Methods and Results: We assessed the prognostic role of three different ranges of in-hospital peak glycemia (180 mg/dl) in 252 acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to percutaneous coronary intervention consecutively admitted to our intensive cardiac care unit (ICCU). Patients with highest peak glycemia showed the highest intra-ICCU mortality (7/44, 15.9%), which was significantly higher with respect to the other two subgroups (P=0.001 and 0.034, respectively). At backward stepwise logistic regression analysis, peak glycemia (odds ratio: 3.14; 95% confidence interval: 1.01-9.74, P=0.047) was an independent predictor of intra-ICCU mortality. Conclusion: In acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to mechanical revascularization, the poorer in-hospital glucose control was associated with higher mortality; peak glycemia greater than 180 mg/dl was associated with the highest mortality, whereas patients with peak glycemia comprised between 140 and 180 mg/dl exhibited intermediate mortality rates. According to our data during hospitalization intensivists should achieve glucose control values less than 140 mg/dl, as peak glycemia resulted in the independent predictor of intra-ICCU mortality.
AB - Background: Acute myocardial infarction is known as an acute metabolic stress, but clinicians currently have limited guidance regarding the evaluation and management of hyperglycemia after revascularization. Methods and Results: We assessed the prognostic role of three different ranges of in-hospital peak glycemia (180 mg/dl) in 252 acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to percutaneous coronary intervention consecutively admitted to our intensive cardiac care unit (ICCU). Patients with highest peak glycemia showed the highest intra-ICCU mortality (7/44, 15.9%), which was significantly higher with respect to the other two subgroups (P=0.001 and 0.034, respectively). At backward stepwise logistic regression analysis, peak glycemia (odds ratio: 3.14; 95% confidence interval: 1.01-9.74, P=0.047) was an independent predictor of intra-ICCU mortality. Conclusion: In acute ST-segment elevation myocardial infarction patients without earlier known diabetes submitted to mechanical revascularization, the poorer in-hospital glucose control was associated with higher mortality; peak glycemia greater than 180 mg/dl was associated with the highest mortality, whereas patients with peak glycemia comprised between 140 and 180 mg/dl exhibited intermediate mortality rates. According to our data during hospitalization intensivists should achieve glucose control values less than 140 mg/dl, as peak glycemia resulted in the independent predictor of intra-ICCU mortality.
KW - acute ST-segment elevation myocardial infarction
KW - in-hospital mortality
KW - nondiabetic
UR - http://www.scopus.com/inward/record.url?scp=77955472701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955472701&partnerID=8YFLogxK
U2 - 10.1097/HJR.0b013e328335f26f
DO - 10.1097/HJR.0b013e328335f26f
M3 - Article
C2 - 20517158
AN - SCOPUS:77955472701
VL - 17
SP - 419
EP - 423
JO - European Journal of Cardiovascular Prevention and Rehabilitation
JF - European Journal of Cardiovascular Prevention and Rehabilitation
SN - 1741-8267
IS - 4
ER -