Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases, ul, Szpitalna 2, 41-800, Zabrze, Poland.
Cardiovasc Diabetol. 2012 Jun 28;11:78. doi: 10.1186/1475-2840-11-78.
Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear.
To assess the incidence and impact of GA on clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI).
A single-center, prospective registry encompassed 2733 consecutive AMI subjects treated with PCI. In all in-hospital survivors (n = 2527, 92.5%) without the history of DM diagnosed before or during index hospitalization standard oral glucose tolerance test (OGTT) was performed during stable condition before hospital discharge and interpreted according to WHO criteria. The mean follow-up period was 37.5 months.
The incidence of GA was as follows: impaired fasting glycaemia - IFG (n = 376, 15%); impaired glucose tolerance - IGT (n = 560, 22%); DM (n = 425, 17%); new onset DM (n = 384, 15%); and normal glucose tolerance - NGT (n = 782, 31%). During the long-term follow-up, death rate events for previously known DM, new onset DM and IGT were significantly more frequent than those for IFG and NGT (12.3; 9.6 and 9.4 vs. 5.6 and 6.4%, respectively, P < 0.05). The strongest and common independent predictors of death in GA patients were glomerular filtration rate < 60 ml/min/1,73 m^2 (HR 2.0 and 2.8) and left ventricle ejection fraction < 35% (HR 2.5 and 1.8, all P < 0.05) respectively.
Glucose abnormalities are very common in AMI patients. DM, new onset DM and IGT increase remote mortality. Impaired glucose tolerance bears similar long-term prognosis as diabetes.
糖尿病（DM）会使冠心病患者的预后恶化。然而，在接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者中，除 DM 以外的不同葡萄糖异常（GA）对临床结局的预测价值尚不清楚。
评估 GA 对接受 PCI 治疗的 AMI 患者临床结局的发生率和影响。
单中心前瞻性登记研究纳入 2733 例连续接受 PCI 治疗的 AMI 患者。所有住院期间存活的患者（n=2527，92.5%）均无 DM 病史，在出院前稳定状态下进行标准口服葡萄糖耐量试验（OGTT），并根据世界卫生组织（WHO）标准进行解读。平均随访时间为 37.5 个月。
GA 的发生率如下：空腹血糖受损（IFG，n=376，15%）、葡萄糖耐量受损（IGT，n=560，22%）、DM（n=425，17%）、新发 DM（n=384，15%）和正常糖耐量（NGT，n=782，31%）。在长期随访中，已知 DM、新发 DM 和 IGT 的死亡率事件明显高于 IFG 和 NGT（分别为 12.3%、9.6%和 9.4%，5.6%和 6.4%，P<0.05）。GA 患者死亡的最强和共同独立预测因素分别为肾小球滤过率<60 ml/min/1.73 m^2（HR 2.0 和 2.8）和左心室射血分数<35%（HR 2.5 和 1.8，均 P<0.05）。
葡萄糖异常在 AMI 患者中非常常见。DM、新发 DM 和 IGT 会增加远期死亡率。IGT 与糖尿病具有相似的长期预后。
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