Document Detail


Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention.
MedLine Citation:
PMID:  16290985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with acute myocardial infarction (MI), increased plasma glucose levels at hospital admission are associated with worse outcome. We aimed to assess the predictive value of admission glucose concentrations on short- and long-term mortality in patients with acute MI undergoing primary or rescue percutaneous coronary intervention (PCI). METHODS: We analyzed the 30-day and long-term (mean follow-up 3.7 years) outcome of 978 patients prospectively included in a single-center registry of patients with acute MI treated with PCI within 24 hours after onset of symptoms. Patients were classified according to plasma glucose levels at admission: < 7.8 mmol/L (group I, n = 322), 7.8 to 11 mmol/L (group II, n = 348), and > 11.0 mmol/L (group III, n = 308). RESULTS: Mortality at 30 days was 1.2% in group I, 6.3% in group II, and 16.6% in group III (P < .001). After multivariate adjustment for age, the presence of cardiogenic shock, and TIMI 3 flow after PCI, the association of mortality with glucose classification remained significant (P value for trend = .003). The relative risk of death at 30 days for group III versus group I was 3.9 (95% CI 1.2-13.2). During long-term follow-up, mortality was similar in groups I and II. However, in group III adjusted mortality remained significantly increased compared with group I (relative risk 1.76, CI 1.01-3.08). CONCLUSIONS: In patients undergoing emergency PCI for acute MI, glucose levels at hospital admission are predictive for short- and long-term survival. Knowledge of admission glucose levels may improve initial bedside risk stratification.
Authors:
Edwin Straumann; David J Kurz; Jörg Muntwyler; Irene Stettler; Marcel Furrer; Barbara Naegeli; Jürgen Frielingsdorf; Ernst Schuiki; Raymond Mury; Osmund Bertel; Giatgen A Spinas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  150     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2005-12-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland. edwin.straumann@triemli.stzh.ch
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Blood Glucose / analysis*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / blood,  mortality*,  therapy*
Patient Admission
Predictive Value of Tests
Prognosis
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Blood Glucose

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