Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era - 21/08/11
, Sunao Kojima, MD, PhD b, Tomohiro Sakamoto, MD, PhD b, Yujiro Asada, MD, PhD c, Chuwa Tei, MD, PhD d, Kazuo Kimura, MD, PhD e, Shunichi Miyazaki, MD, PhD f, Masahiro Sonoda, MD, PhD g, Kazufumi Tsuchihashi, MD, PhD h, Masakazu Yamagishi, MD, PhD f, Yoshihiko Ikeda, MD, PhD i, Mutsunori Shirai, MD, PhD j, Hisatoyo Hiraoka, MD, PhD k, Takeshi Inoue, MD, PhD l, Fumio Saito, MD, PhD m, Hisao Ogawa, MD, PhD bon behalf of the Japanese Acute Coronary Syndrome Study (JACSS) Investigators Japan Hiroshima, Japan⁎
Résumé |
Purpose |
This study was undertaken to assess the association between acute hyperglycemia and inhospital outcome after acute myocardial infarction (AMI) in the percutaneous coronary intervention (PCI) era. We also assessed outcome of patients with a history of diabetes mellitus in the PCI era.
Methods |
Between January 2001 and December 2001, 1253 patients were admitted to the hospitals within 48 hours after the onset of AMI. Plasma glucose was measured at hospital admission. Acute hyperglycemia was defined as plasma glucose of >11 mmol/L (198 mg/dL), regardless of the diabetic status. Primary PCI was performed in 898 (72%) patients.
Results |
The inhospital mortality rate was significantly higher in patients with acute hyperglycemia than in patients without (16% vs 6%, P < .001). However, there was no significant difference in mortality between diabetic and nondiabetic patients (8% vs 9%, P = .54). Acute hyperglycemia was associated with a higher inhospital mortality rate both in nondiabetic patients (24% vs 6%, P < .001) and in diabetic patients (10% vs 5%, P = .039). Acute hyperglycemia was associated with a higher incidence of no reflow during PCI (21% vs 12%, P < .001), but diabetes was not (14% vs 15%, P = .71).
Conclusion |
Acute hyperglycemia, but not diabetes, was a predictor for inhospital mortality after AMI in the PCI era. No reflow occurred more frequently during PCI in patients with acute hyperglycemia, suggesting that microvascular dysfunction might have contributed to adverse outcome of these patients.
Le texte complet de cet article est disponible en PDF.Plan
| This study was supported by the Research Grant for Cardiovascular Disease (14C-4) from the Ministry of Health, Labor, and Welfare. |
Vol 150 - N° 4
P. 814-820 - octobre 2005 Retour au numéro
Article précédent
- Sirolimus-eluting stent implantation in diabetic patients with multivessel coronary artery disease
- Carlo Briguori, Antonio Colombo, Flavio Airoldi, Amelia Focaccio, Ioannis Iakovou, Alaide Chieffo, Iassen Michev, Matteo Montorfano, Erminio Bonizzoni, Bruno Ricciardelli, Gerolama Condorelli
- Obesity and clinical restenosis after coronary stent placement
- Jamal S. Rana, Murray A. Mittleman, Kalon K. Ho, Donald E. Cutlip
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?