Document Detail


Impact of Acute and Chronic Hyperglycemia on In-Hospital Outcomes of Patients With Acute Myocardial Infarction.
MedLine Citation:
PMID:  25438903     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
This study was undertaken to assess the impact of acute hyperglycemia (acute-HG) and chronic hyperglycemia (chronic-HG) on short-term outcomes in patients with acute myocardial infarction (AMI). This study consisted of 696 patients with AMI. Acute-HG was defined as admission plasma glucose ≥200 mg/dl and chronic-HG as hemoglobin A1c ≥6.5%. Acute-HG was associated with higher peak serum creatine kinase (4,094 ± 4,594 vs 2,526 ± 2,227 IU/L, p <0.001) and in-hospital mortality (9.8% vs 1.6%, p <0.001). On the contrary, there was no significant difference in peak creatine kinase (2,803 ± 2,661 vs 2,940 ± 3,181 IU/L, p = 0.59) and mortality (3.3 vs 3.7%, p = 0.79) between patients with chronic-HG and those without. Multivariate analysis showed that admission plasma glucose was an independent predictor of in-hospital mortality (odds ratio 1.15, 95% confidence interval 1.05 to 1.27, p <0.001), but hemoglobin A1c was not. When only patients with acute-HG were analyzed, chronic-HG was associated with a significantly smaller infarct size (3,221 ± 3,001 vs 5,904 ± 6,473 IU/L, p <0.001) and lower in-hospital mortality (5.5 vs 18.9%, p = 0.01). In conclusion, these results suggested that acute-HG, but not chronic-HG, was associated with adverse short-term outcomes after AMI. Paradoxically, in patients with acute-HG, chronic-HG might abate the adverse effects of acute-HG.
Authors:
Masashi Fujino; Masaharu Ishihara; Satoshi Honda; Shoji Kawakami; Takafumi Yamane; Toshiyuki Nagai; Kazuhiro Nakao; Tomoaki Kanaya; Leon Kumasaka; Yasuhide Asaumi; Tetsuo Arakawa; Yoshio Tahara; Michio Nakanishi; Teruo Noguchi; Kengo Kusano; Toshihisa Anzai; Yoichi Goto; Satoshi Yasuda; Hisao Ogawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  114     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1789-1793     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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