Hao Yuanyuan, Lu Qun, Li Tao, Yang Guodong, Hu Peijing, Ma Aiqun
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Shaanxi Key Laboratory of Molecular Cardiology (Xi'an Jiaotong University), Xi'an, China.
BMC Cardiovasc Disord. 2017 Jan 5;17(1):6. doi: 10.1186/s12872-016-0441-x.
The association between admission hyperglycemia and adverse outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) has not been well studied, and the optimal plasma glucose cut-off values for prognosis for NSTEMI patients with and without diabetes have not been determined.
According to glucose level and diabetes status, consecutive NSTEMI patients undergoing PCI (n = 890) were divided into four groups: without diabetes mellitus (DM) and admission plasma glucose (APG) <144 or ≥144 mg/dL; or with DM and APG <180 or ≥180 mg/dL. All patients were followed up at 30 days and 3 years after discharge, and the outcomes were assessed.
Admission hyperglycemia was found in 44 and 28% of the DM and non-DM patients, respectively. Multivariable analyses showed that the APG level was an independent predictor of 30-day and 3-year MACEs. Receiver operating characteristic curve analysis revealed that the appropriate cut-off values were 178 and 145 mg/dL for patients with and without DM, respectively, or 157 mg/dL for all patients.
Admission hyperglycemia may be used to predict 30-day and 3-year MACEs in patients with NSTEMI undergoing PCI, irrespective of diabetes status. However, the optimal admission glucose cut-off values for predicting prognosis differ for patients with or without DM.
非ST段抬高型心肌梗死（NSTEMI）患者接受经皮冠状动脉介入治疗（PCI）时，入院时高血糖与不良预后之间的关联尚未得到充分研究，且尚未确定合并或不合并糖尿病的NSTEMI患者预后的最佳血糖临界值。
根据血糖水平和糖尿病状态，将连续接受PCI的NSTEMI患者（n = 890）分为四组：无糖尿病（DM）且入院时血浆葡萄糖（APG）<144或≥144 mg/dL；或合并DM且APG<180或≥180 mg/dL。所有患者在出院后30天和3年进行随访，并评估预后。
DM患者和非DM患者入院时高血糖的发生率分别为44%和28%。多变量分析显示，APG水平是30天和3年主要不良心血管事件（MACE）的独立预测因素。受试者工作特征曲线分析显示，合并DM和未合并DM患者的合适临界值分别为178和145 mg/dL，或所有患者的临界值为157 mg/dL。
入院时高血糖可用于预测接受PCI的NSTEMI患者30天和3年的MACE，无论糖尿病状态如何。然而，合并或未合并DM患者预测预后的最佳入院血糖临界值不同。
