Li Dong-bao, Hua Qi, Guo Jincheng, Li Hong-wei, Chen Hui, Zhao Shu-mei
Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, China.
Intern Med. 2011;50(21):2471-5. doi: 10.2169/internalmedicine.50.5750. Epub 2011 Nov 1.
Hyperglycemia on admission is a predictor of an unfavorable prognosis in patients with ST-elevation Acute Myocardial Infarction (AMI). Data concerning associations between an elevated glucose level on admission and other in-hospital complications are still limited.
A total of 1,137 AMI patients with complete admission blood glucose level (ABGL) analysis were identified and stratified according to ABGL.
A total of 16.1% patients had admission glucose level <5 mmol/L, 36.1% <7 mmol/L, 20.2% <9 mmol/L, 9.9% <11 mmol/L and 17.7% ≥11 mmol/L. Compared with the euglycemia group, both the hypo- and hyperglycemia groups were associated with higher in-hospital mortality. In-hospital mortality of diabetic patients with hypoglycemia (12.2%) was higher than that of diabetic patients with either euglycemia or mild hyperglycemia (11.1%, or 10.7% relatively). The same results were seen in non-diabetic patients. In the logistic regression analysis, admission glucose and cardiac function of Killip grade were the independent predictors of in-hospital death for patients with AMI.
Elevated admission glucose levels are associated with an increased risk of life-threatening complications in diabetic and non-diabetic AMI patients. Compared with the euglycemia group, hypoglycemia was associated with a higher trend of in-hospital mortality.
入院时高血糖是ST段抬高型急性心肌梗死（AMI）患者预后不良的预测指标。关于入院时血糖水平升高与其他院内并发症之间关联的数据仍然有限。
共纳入1137例有完整入院血糖水平（ABGL）分析的AMI患者，并根据ABGL进行分层。
共有16.1%的患者入院血糖水平<5 mmol/L，36.1%<7 mmol/L，20.2%<9 mmol/L，9.9%<11 mmol/L，17.7%≥11 mmol/L。与血糖正常组相比，低血糖组和高血糖组的院内死亡率均较高。低血糖糖尿病患者的院内死亡率（12.2%）高于血糖正常或轻度高血糖糖尿病患者（分别为11.1%或10.7%）。非糖尿病患者也有同样的结果。在逻辑回归分析中，入院血糖和Killip分级的心脏功能是AMI患者院内死亡的独立预测因素。
入院血糖水平升高与糖尿病和非糖尿病AMI患者发生危及生命并发症的风险增加有关。与血糖正常组相比，低血糖与院内死亡率升高趋势相关。
