In-hospital peak glycemia and prognosis in STEMI patients without earlier known diabetes

Chiara Lazzeri, Serafina Valente, Marco Chiostri, Claudio Picariello, Gian Franco Gensini

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)419-423
Number of pages5
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Volume17
Issue number4
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Intensive Care Units
Mortality
Glucose
Physiological Stress
Percutaneous Coronary Intervention
Hyperglycemia
ST Elevation Myocardial Infarction
Hospitalization
Logistic Models
Odds Ratio
Myocardial Infarction
Regression Analysis
Confidence Intervals

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 journalArticle

Lazzeri, Chiara ; Valente, Serafina ; Chiostri, Marco ; Picariello, Claudio ; Gensini, Gian Franco. / In-hospital peak glycemia and prognosis in STEMI patients without earlier known diabetes. In: European Journal of Cardiovascular Prevention and Rehabilitation. 2010 ; Vol. 17, No. 4. pp. 419-423.
@article{d894ca25b62c41a698a8e7baf0c0ab75,
title = "In-hospital peak glycemia and prognosis in STEMI patients without earlier known diabetes",
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.",
keywords = "acute ST-segment elevation myocardial infarction, in-hospital mortality, nondiabetic",
author = "Chiara Lazzeri and Serafina Valente and Marco Chiostri and Claudio Picariello and Gensini, {Gian Franco}",
year = "2010",
month = "8",
doi = "10.1097/HJR.0b013e328335f26f",
language = "English",
volume = "17",
pages = "419--423",
journal = "European Journal of Cardiovascular Prevention and Rehabilitation",
issn = "1741-8267",
publisher = "SAGE Publications Inc.",
number = "4",

}

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 -