Effect of Admission Hyperglycemia on Mortality in Diabetic and Non-diabetic Geriatric Patients with Non-ST-segment Elevation Myocardial Infarction

• Published in: Kardiyovasküler tıp e dergisi Vol. 10; no. 2; pp. 72 - 82
• Main Authors: Demir Gündoğmuş, Pınar, Keskin, Ümran
• Format: Journal Article
• Language: English
• Published: Ismir Galenos Publishing House 01-06-2022
• Subjects: Angioplasty; Anticoagulants; Blood pressure; Cardiovascular disease; Coronary vessels; Diabetes; Electrocardiography; Emergency medical care; Enzymes; Geriatrics; Glucose; Heart attacks; Heart rate; Hospitalization; Hyperglycemia; Hypertension; Medical imaging; Mortality; Plasma; Vein & artery diseases
• ISSN: 2147-1924; 2147-1924
• DOI: 10.32596/ejcm.galenos.2022.2021-12-072

Objectives: High level of admission plasma glucose (APG) in myocardial infarction is associated with an increased risk of death in previous studies; however, most studies that evaluated this relationship were conducted before the guideline-based definition of hyperglycemia. This study was designed to assess the prognostic significance of APG and admission hyperglycemia in patients with and without diabetes mellitus (DM). Materials and Methods: Five hundred and twenty-seven geriatric patients with non-ST segment elevation myocardial infarction (NSTEMI) were enrolled in the study. Patients were divided into four groups according to APG and DM status: those with DM, those with APG <144 mg/dL were named group 1, and those with APG ≥144 mg/dL were named group 2. Those without DM, those with APG <180 mg/dL were called group 3, and those with APG≥ 180 mg/dL were named group 4. Results: Hyperglycemia was common in diabetic and nondiabetic patients threatening 29% of the study population. Patients without hyperglycemia (Groups 1 and 3) had the least mortality rates in one-month follow-up. In one-year follow-up, the patients with hyperglycemia (Group 2 and 4) had higher mortality rates (22.6% and 23.3%, respectively) than those with no-hyperglycemia groups. In regression analysis, hyperglycemia was independently associated with one-month and one-year mortality. In receiver operating characteristics curve analysis, the discriminative value of APG for one-month and one-year mortality was good in the groups. Conclusion: APG may be used to predict one-month and one-year death irrespective of DM status. Therefore, DM and admission hyperglycemia could not be considered and treated as similar situations.