Department of Cardiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Rom J Intern Med. 2022 Mar 17;60(1):34-41. doi: 10.2478/rjim-2021-0033. Print 2022 Mar 1.
Admission hyperglycemia has been associated with major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome. In this study we sought to determine the association between admission blood sugar (ABS) and the outcomes of non-diabetic patients with first-ever acute myocardial infarction (MI). Non-diabetic patients with MI were evaluated from March 2016 to March 2019. Baseline characteristics, laboratories, electrocardiogram, and baseline left ventricular ejection fraction (LVEF) were recorded. All patients were followed up and outcomes were obtained. Follow-up data comprised of repeating electrocardiogram and echocardiography at 1 year, and MACCE, including re-MI, stroke, and mortality. A total of 312 patients with a mean age of 54.2 ± 11.9 years were evaluated. All patients were followed up for a median of 38 months. The frequencies of in-hospital mortality and MACCE at late follow-up were higher in third tertile of ABS compared with those in first and second tertiles (both p <0.05). Based on the Cox regression analysis, the independent predictors of MACCE included age (hazard ratio [HR] 1.068, 95% confidence interval [CI] 1.033 - 1.105, p <0.001), third tertile of ABS >172 mg/dL (HR 21.257, 95% CI 2.832 - 159.577, p=0.003), and baseline LVEF (HR 0.947, 95% CI 0.901 - 0.995, p=0.031). Admission stress hyperglycemia is associated with increased rates of in-hospital mortality and MACCE at late follow-up in non-diabetic patients with MI. Moreover, elevated ABS, older ages, and a decreased value of baseline LVEF predicted MACCE during follow-up.
入院时的高血糖与急性冠状动脉综合征患者的主要不良心脑血管事件（MACCE）有关。在这项研究中，我们旨在确定首次急性心肌梗死（MI）的非糖尿病患者入院血糖（ABS）与结局之间的关系。从 2016 年 3 月到 2019 年 3 月，评估了非糖尿病性 MI 患者。记录了基线特征、实验室、心电图和基线左心室射血分数（LVEF）。对所有患者进行了随访并获得了结果。随访数据包括 1 年时重复心电图和超声心动图，以及 MACCE，包括再发性 MI、中风和死亡率。共评估了 312 名平均年龄为 54.2 ± 11.9 岁的患者。所有患者的中位随访时间为 38 个月。与第一和第二三分位相比，第三三分位的 ABS 患者住院死亡率和晚期随访时的 MACCE 频率更高（均 p <0.05）。基于 Cox 回归分析，MACCE 的独立预测因素包括年龄（危险比 [HR] 1.068，95%置信区间 [CI] 1.033-1.105，p <0.001）、第三三分位的 ABS >172mg/dL（HR 21.257，95%CI 2.832-159.577，p=0.003）和基线 LVEF（HR 0.947，95%CI 0.901-0.995，p=0.031）。入院应激性高血糖与 MI 后非糖尿病患者晚期住院死亡率和 MACCE 发生率增加有关。此外，升高的 ABS、年龄较大和基线 LVEF 值降低预测了随访期间的 MACCE。
