TY - JOUR
T1 - In patients with ST-segment elevation myocardial infarction with cardiogenic shock treated with percutaneous coronary intervention, admission glucose level is a strong independent predictor for 1-year mortality in patients without a prior diagnosis of diabetes
AU - Vis, Marije M.
AU - Sjauw, Krischan D.
AU - van der Schaaf, Rene J.
AU - Baan, Jan
AU - Koch, Karel T.
AU - DeVries, J. Hans
AU - Tijissen, Jan G. P.
AU - de Winter, Robbert J.
AU - Piek, Jan J.
AU - Henriques, Jose P. S.
PY - 2007
Y1 - 2007
N2 - Background Primary percutaneous coronary intervention (PCI) reduces mortality in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Despite PCI, mortality in CS is still approximately 50%. Admission glucose concentration is an independent predictor of mortality in patients with STEMI and is associated with the occurrence of CS. Whether admission glucose is also a predictor of mortality in CS patients treated with primary PCI is unexplored. We therefore assessed the relation between admission glucose concentration and 1-year mortality in patients with STEMI with CS without a prior diagnosis of diabetes on admission and treated with PCI. Methods We investigated a cohort of 208 consecutive patients with STEMI without a prior diagnosis of diabetes with CS on admission. Patients were classified according to glucose levels at admission: <7.8 mmol/L (group 1, n = 57), 7.8 to 11 mmol/L (group 2, n = 71), and >11.0 mmol/L (group 3, n = 80). Results The overall 1-year mortality was 38%. One-year mortality was 21%, 27%, and 60% in groups 1, 11, and 111, respectively (P <.001). In a multivariate logistic regression analysis, the odds for Mortality increased by 16% for every I mmol/L increase in plasma glucose concentration (OR 1.155, 95% Cl 1.070-1.247), after adjustment for left ventricular ejection fraction <40%, age older than 75 years, male sex, and thrombolysis in myocardial infarction 3 flow after PCI. Conclusions in patients with STEMI with CS and without a prior diagnosis of diabetes undergoing primary PCI, admission glucose concentration is a very strong independent predictor for 1-year mortality. Further studies are warranted to determine whether concomitant glycometabolic regulation in patients with STEMI treated with PCI, particularly those with CS, will improve clinical outcome
AB - Background Primary percutaneous coronary intervention (PCI) reduces mortality in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Despite PCI, mortality in CS is still approximately 50%. Admission glucose concentration is an independent predictor of mortality in patients with STEMI and is associated with the occurrence of CS. Whether admission glucose is also a predictor of mortality in CS patients treated with primary PCI is unexplored. We therefore assessed the relation between admission glucose concentration and 1-year mortality in patients with STEMI with CS without a prior diagnosis of diabetes on admission and treated with PCI. Methods We investigated a cohort of 208 consecutive patients with STEMI without a prior diagnosis of diabetes with CS on admission. Patients were classified according to glucose levels at admission: <7.8 mmol/L (group 1, n = 57), 7.8 to 11 mmol/L (group 2, n = 71), and >11.0 mmol/L (group 3, n = 80). Results The overall 1-year mortality was 38%. One-year mortality was 21%, 27%, and 60% in groups 1, 11, and 111, respectively (P <.001). In a multivariate logistic regression analysis, the odds for Mortality increased by 16% for every I mmol/L increase in plasma glucose concentration (OR 1.155, 95% Cl 1.070-1.247), after adjustment for left ventricular ejection fraction <40%, age older than 75 years, male sex, and thrombolysis in myocardial infarction 3 flow after PCI. Conclusions in patients with STEMI with CS and without a prior diagnosis of diabetes undergoing primary PCI, admission glucose concentration is a very strong independent predictor for 1-year mortality. Further studies are warranted to determine whether concomitant glycometabolic regulation in patients with STEMI treated with PCI, particularly those with CS, will improve clinical outcome
U2 - https://doi.org/10.1016/j.ahj.2007.07.028
DO - https://doi.org/10.1016/j.ahj.2007.07.028
M3 - Article
C2 - 18035093
SN - 0002-8703
VL - 154
SP - 1184
EP - 1190
JO - American Heart Journal
JF - American Heart Journal
IS - 6
ER -