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Article Dans Une Revue Diabetic Medicine Année : 2006

Predictive value of admission hyperglycaemia on mortality in patients with acute myocardial infarction.

F. Schiele
  • Fonction : Auteur
V. Descotes-Genon
  • Fonction : Auteur
M. F. Seronde
  • Fonction : Auteur
M. C. Blonde
  • Fonction : Auteur
P. Legalery
  • Fonction : Auteur
N. Meneveau
  • Fonction : Auteur
Fiona Ecarnot
L. Thebault
  • Fonction : Auteur
D. Boumal
  • Fonction : Auteur
J.-P. Bassand
  • Fonction : Auteur
Non Renseigné
  • Fonction : Auteur

Résumé

RATIONALE AND AIM: In patients with an acute myocardial infarction, admission hyperglycaemia (AH) is a major risk factor for mortality. However, the predictive value of AH, when the risk score and use of guidelines-recommended treatments are considered, is poorly documented. METHODS: The first fasting plasma glucose levels after admission, risk level, guidelines-recommended treatment use and 1-year mortality were recorded. Patients with first fasting glucose level after admission > 7.7 mmo/l were considered to have AH. RESULTS: Three hundred and twenty patients with ST segment elevation myocardial infarction (STEMI) and 404 with non-ST segment elevation myocardial infarction (NSTEMI) were included. One hundred and seventy-five (24%) patients had pre-existing diabetes (diabetes group), 154 (21%) had AH (AH+ group) and the remainding 395 (55%) had neither diabetes nor AH (AH- group). The Global Registry of Acute Coronary Events (GRACE) risk score was lower in the AH- group, but the use of guidelines-recommended treatment was comparable in all groups. At 1 year, the mortality rate was higher in the AH+ group compared with the AH- group (18.8 vs. 6.1%, P < 0.01) and similar to that in the diabetes group (18.8 vs. 16.6%, P = NS). The relation between glycaemic status and mortality remained strong [AH+ vs. AH-, OR = 3.0 (1.5, 6.0) and diabetes vs. AH-, OR = 3.6 (1.7, 6.6)] after adjustment for the GRACE risk score [OR = 2.4 (1.8, 3.1) per 10% increase] and for treatment score [OR = 0.7 (0.6, 0.8) per 10% increase]. CONCLUSIONS: In patients without a history of diabetes, the presence of AH indicates an increased risk of 1-year mortality, similar to that of patients with diabetes, even when the risk score and use of guidelines-recommended treatment are controlled for.

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Cancer

Dates et versions

hal-00493654 , version 1 (21-06-2010)

Identifiants

Citer

F. Schiele, V. Descotes-Genon, M. F. Seronde, M. C. Blonde, P. Legalery, et al.. Predictive value of admission hyperglycaemia on mortality in patients with acute myocardial infarction.. Diabetic Medicine, 2006, 23 (12), pp.1370-1376. ⟨10.1111/j.1464-5491.2006.02000.x⟩. ⟨hal-00493654⟩

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