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Am Heart J. 2004 Sep;148(3):399-404.

Prognostic value of admission glucose in non-diabetic patients with myocardial infarction.

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Department of Cardiology, Isala Klinieken, locatie Weezenlanden, Zwolle, The Netherlands.



Patients with acute myocardial infarction (AMI) who have diabetes have an increased risk of death. In nondiabetic patients, admission glucose levels may be a predictor of survival. However, data regarding admission glucose and long-term outcome in nondiabetic patients treated with reperfusion therapy for AMI are limited.


We investigated long-term clinical outcome in 356 consecutive nondiabetic patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention or thrombolysis as reperfusion therapy. Mean follow-up time was 8 +/- 2 years. The patients were divided on the basis of admission glucose level: group 1, <7.8 mmol/L; group 2, 7.8 to 11.0 mmol/L; and group 3, > or =11.1 mmol/L.


Mortality rate in group 1 (n = 163) was 19.0%; in group 2 (n = 151), 26.5%; and in group 3 (n = 42), 35.7% (P <.05). Higher glucose levels were associated with larger enzymatic infarct sizes (P <.01) and more reduced residual left ventricular function (P <.05). Multivariate analysis showed that Killip class >1 at admission (OR, 2.9; 95% CI, 1.7 to 5.0; P <.001), age > or =60 years (OR, 2.4; 95% CI, 1.5 to 4.0, P =.001), thrombolysis as compared with percutaneous coronary intervention (OR, 1.7; 95% CI, 1.1 to 2.7, P =.02), admission glucose category (OR, 1.4; 95% CI, 1.0 to 1.9, P =.04), and anterior location (OR, 1.6; 95% CI, 1.0 to 2.6, 0.03) were independent predictors of long-term clinical outcome.


Elevated admission glucose levels in nondiabetic patients treated with reperfusion therapy for ST-segment elevation myocardial infarction are independently associated with larger infarct size and higher long-term mortality rates.

[Indexed for MEDLINE]

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