Impact of Fasting Glycemia on Short-Term Prognosis after Acute Myocardial Infarction

• Published in: The journal of clinical endocrinology and metabolism Vol. 92; no. 6; pp. 2136 - 2140
• Main Authors: Vergès, Bruno, Zeller, Marianne, Dentan, Gilles, Beer, Jean-Claude, Laurent, Yves, Janin-Manificat, Luc, Makki, Hamid, Wolf, Jean Eric, Cottin, Yves
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01-06-2007
• Subjects: Aged; Biological and medical sciences; Blood Glucose - metabolism; Cohort Studies; Diabetes Mellitus - metabolism; Diabetes Mellitus - mortality; Fasting; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Hyperglycemia - metabolism; Hyperglycemia - mortality; Male; Middle Aged; Morbidity; Myocardial Infarction - metabolism; Myocardial Infarction - mortality; Prevalence; Prognosis; Risk Factors; ROC Curve; Sensitivity and Specificity; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Short term; Myocardial infarction; Fasting; Prognosis; Nutrition; Acute; Cardiovascular disease; Metabolic diseases; Myocardial disease; Heart disease; Fast; Endocrinology; Glycemia
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2006-2584

Objective: The prognosis of patients with acute myocardial infarction (MI), according to the new criteria for impaired fasting glucose (IFG) (FG 100–126 mg/dl), has not been evaluated.
Research Design and Methods: A total of 2353 patients with acute MI and surviving at d 5 after admission were analyzed for short-term morbidity and mortality. FG was obtained at d 4 and 5. Patients were classified as diabetes mellitus (known diabetes or FG ≥ 126 mg/dl), high IFG (110 ≤ FG < 126 mg/dl), low IFG (100 ≤ FG < 110 mg/dl), and normal fasting glucose (NFG) (FG < 100 mg/dl).
Results: Among the 2353 patients, 968 (41%) had diabetes mellitus, 262 (11%) had high IFG, 332 (14%) had low IFG, and 791 (34%) had NFG. Compared with NFG patients, 30-d cardiovascular mortality was increased in high but not low IFG subjects. In-hospital heart failure was increased in high IFG subjects (42 vs. 20% for NFG, P < 0.0001) but not low IFG subjects (21 vs. 20%). High IFG, but not low IFG, was an independent factor associated with 30-d cardiovascular mortality [odds ratio 2.33 (1.55–3.47)] and in-hospital heart failure [odds ratio 1.70 (1.36–2.07)]. The optimal threshold levels of FG on the receiver-operating characteristic curves were 114 and 112 mg/dl to predict mortality and in-hospital heart failure, respectively.
Conclusion: The present study, based on a nonselected cohort of MI patients, underscores the high prevalence of IFG (25%) and highlights the clinical relevance of 110 mg/dl, but not 100 mg/dl, as a cutoff value to define the risk for worse outcome.