Admission hyperglycemia and adverse outcomes in diabetic and non-diabetic patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary interventionReportar como inadecuado




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BMC Cardiovascular Disorders

, 17:6

Coronary artery disease

Abstract

BackgroundThe 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.

MethodsAccording 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.

ResultsAdmission 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.

ConclusionsAdmission 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.

KeywordsNon-ST-elevation myocardial infarction Diabetes mellitus Hyperglycemia Major adverse cardiac events AbbreviationsACEIAngiotensin-converting enzyme inhibitor

ADAAmerican Diabetes Association

AMIAcute myocardial infarction

APGAdmission plasma glucose level

ARBAngiotensin receptor blocker

AUCArea under curve

CABGCoronary artery bypass grafting

CADCoronary artery disease

CCBCALCIUM channel blocker

CIConfidence interval

CK-MBCreatine kinase-myocardial band

cTnICardiac troponin I

DMDiabetes mellitus

ECGElectrocardiograph

HDLHigh density lipoprotein

HFHeart failure

HRHazard ratio

IQRInterquartile range

LADLeft anterior descending

LDLLow density lipoprotein

LMLeft main coronary artery

LVEFLeft-ventricular ejection fraction

MACEsMajor adverse cardiac events

MIMyocardial infarction

NSTEMINon-ST-elevation myocardial infarction

OROdds ratios

PCIPercutaneous coronary intervention

ROCReceiver operator characteristic

RRRelative risk

SDStandard deviation

STEMIST-segment elevation myocardial infarction

TCSerum total cholesterol

TGTriglyceride

TIMIThrombolysis in myocardial infarction

TVRTarget vessel revascularization

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Autor: Yuanyuan Hao - Qun Lu - Tao Li - Guodong Yang - Peijing Hu - Aiqun Ma

Fuente: https://link.springer.com/







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