Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients

Knudsen, Eva Cecilie; Seljeflot, Ingebjørg; Abdelnoor, Michael; Eritsland, Jan; Mangschau, Arild; Arnesen, Harald; Andersen, Geir Øystein

doi:10.1186/1475-2840-8-6

Cited by 71 publications

(86 citation statements)

References 19 publications

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“…25 The original finding in the GAMI study that as many as two-thirds of patients with AMI have previously unknown, AGT has subsequently been confirmed by several studies in people with unstable as well as stable coronary artery disease. [8][9][10]26 An OGTT performed earlier than 4-5 days after an acute coronary syndrome may give erroneous results due to a stress-induced increased adrenergic tone 27 and since discharge from hospital today frequently are within a few days, the best option may be to prescribe the Table 3. Events in patients and controls by glucometabolic status until death or 31 December 2011.…”

Section: Resultsmentioning

confidence: 99%

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: Long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

Ritsinger

Tanoglidi

Malmberg

et al. 2014

Diabetes and Vascular Disease Research

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Objective: To investigate long-term prognostic importance of newly discovered glucose disturbances in patients with acute myocardial infarction (AMI). Methods: During 1998-2001, consecutive patients with AMI (n = 167) and healthy controls (n = 184) with no previously known diabetes were investigated with an oral glucose tolerance test (OGTT). Patients and controls were separately followed up for cardiovascular events (first of cardiovascular mortality/AMI/stroke/heart failure) during a decade. Results: In all, 68% of the patients and 35% of the controls had newly detected abnormal glucose tolerance (AGT). Cardiovascular event (n = 72, p = 0.0019) and cardiovascular mortality (n = 31, p = 0.031) were more frequent in patients with newly detected AGT. Regarding patients, a Cox proportional-hazard regression analysis identified AGT (hazard ratio (HR): 2.30; 95% confidence interval (CI): 1.24-4.25; p = 0.008) and previous AMI (HR: 2.39; CI: 1.31-4.35; p = 0.004) as prognostically important. Conclusion: An OGTT at discharge after AMI disclosed a high proportion of patients with previously unknown AGT which had a significant and independent association with long-term prognosis.

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Section: Resultsmentioning

confidence: 99%

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: Long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

Ritsinger

Tanoglidi

Malmberg

et al. 2014

Diabetes and Vascular Disease Research

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“…It is well known that a number of STEMI patients have undetected diabetes mellitus, and they were not excluded in our study. 15,26 Indeed, when the HbA 1c cutoff value of Ն6.5% as suggested by the American Diabetes Association was used, Ϸ5% of our population could readily be diagnosed with diabetes mellitus on admission (undiagnosed diabetes mellitus), and they were not excluded from the main analysis. 27 However, because there was a stepwise increase in mortality with increasing HbA 1c levels starting from the lowest to the highest quartile, we believe that our findings are not solely attributable to the number of patients with undetected diabetes mellitus.…”

Section: Study Limitationsmentioning

confidence: 99%

Prognostic Value of Admission Glycosylated Hemoglobin and Glucose in Nondiabetic Patients With ST-Segment–Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention

et al. 2011

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Background-In nondiabetic patients with ST-segment-elevation myocardial infarction, acute hyperglycemia is associated with adverse outcome. Whether this association is due merely to hyperglycemia as an acute stress response or whether longer-term glycometabolic derangements are also involved is uncertain. It was our aim to determine the association between both acute and chronic hyperglycemia (hemoglobin A 1c [HbA 1c ]) and outcome in nondiabetic patients with ST-segment-elevation myocardial infarction. Methods and Results-This observational study included consecutive patients (nϭ4176) without known diabetes mellitus admitted with ST-segment-elevation myocardial infarction. All patients were treated with primary percutaneous intervention. Both glucose and HbA 1c were measured on admission. Main outcome measure was total long-term mortality; secondary outcome measures were 1-year mortality and enzymatic infarct size. One-year mortality was 4.7%, and mortality after total follow-up (3.3Ϯ1.5 years) was 10%. Both elevated HbA 1c levels (PϽ0.001) and elevated admission glucose (PϽ0.001) were associated with 1-year and long-term mortality. After exclusion of early mortality (within 30 days), HbA 1c remained associated with long-term mortality (PϽ0.001), whereas glucose lost significance (Pϭ0.09). Elevated glucose, but not elevated HbA 1c , was associated with larger infarct size. After multivariate analysis, HbA 1c (hazard ratio, 1.2 per interquartile range; PϽ0.01), but not glucose, was independently associated with long-term mortality. Conclusions-In nondiabetic patients with ST-segment-elevation myocardial infarction, both elevated admission glucose and HbA 1c levels were associated with adverse outcome. Both of these parameters reflect different patient populations, and their association with outcome is probably due to different mechanisms. Measurement of both parameters enables identification of these high-risk groups for aggressive secondary risk prevention. (Circulation. 2011;124:704-711.)

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“…Oral glukosetoleransetest er i noen studier vist å ha prognostisk verdi og kan vurderes etter en akutt koronar hendelse, men anbefales ikke som fast rutine (13,14,(16)(17)(18).…”

Section: Diskusjonunclassified

Prevalence of diabetes before and after first diagnosis of coronary artery disease

Jortveit¹,

Kaldal²,

Tonstad³

2018

Tidsskriftet

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Forekomst av diabetes før og etter første gangs koronarsykdom | Tidsskrift for Den norske legeforening SERENA TONSTADSeksjon for preventiv kardiologi Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin Oslo universitetssykehus Hun har bidratt med idé, utforming, tolkning av data, litteratursøk og utarbeiding/revisjon og har godkjent innsendte manusversjon. Serena Tonstad er overlege ved Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin, ved OUS. Forfatter har fylt ut ICMJE-skjemaet og oppgir følgende interessekonflikter: Hun har mottatt honorar fra AstraZeneca, Boehringer-Ingelheim, Novo-Nordisk og MSD. BAKGRUNN

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Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients

Cited by 71 publications

References 19 publications

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: Long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: Long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

Prognostic Value of Admission Glycosylated Hemoglobin and Glucose in Nondiabetic Patients With ST-Segment–Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention

Prevalence of diabetes before and after first diagnosis of coronary artery disease

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