BackgroundDiabetes mellitus and admission blood glucose are important risk factors for
mortality in ST segment elevation myocardial infarction patients, but their
relative and individual role remains on debate.ObjectiveTo analyze the influence of diabetes mellitus and admission blood glucose on the
mortality of ST segment elevation myocardial infarction patients submitted to
primary coronary percutaneous intervention.MethodsProspective cohort study including every ST segment elevation myocardial
infarction patient submitted to primary coronary percutaneous intervention in a
tertiary cardiology center from December 2010 to May 2012. We collected clinical,
angiographic and laboratory data during hospital stay, and performed a clinical
follow-up 30 days after the ST segment elevation myocardial infarction. We
adjusted the multivariate analysis of the studied risk factors using the variables
from the GRACE score.ResultsAmong the 740 patients included, reported diabetes mellitus prevalence was 18%. On
the univariate analysis, both diabetes mellitus and admission blood glucose were
predictors of death in 30 days. However, after adjusting for potential confounders
in the multivariate analysis, the diabetes mellitus relative risk was no longer
significant (relative risk: 2.41, 95% confidence interval: 0.76 - 7.59; p-value:
0.13), whereas admission blood glucose remained and independent predictor of death
in 30 days (relative risk: 1.05, 95% confidence interval: 1.02 - 1.09; p-value ≤
0.01).ConclusionIn ST segment elevation myocardial infarction patients submitted to primary
coronary percutaneous intervention, the admission blood glucose was a more
accurate and robust independent predictor of death than the previous diagnosis of
diabetes. This reinforces the important role of inflammation on the outcomes of
this group of patients.
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