The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively Full Text
Cardiovascular Diabetology, 06/29/2012
Mazurek M et al. – Glucose abnormalities are very common in acute myocardial infarction (AMI) patients. Diabetes (DM), new onset DM and IGT increase remote mortality. Impaired glucose tolerance bears similar long–term prognosis as diabetes.Methods
- 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.