Age-dependent differences in diabetes and acute hyperglycemia between men and women with ST-elevation myocardial infarction: a cohort study

Abstract

BackgroundBoth acute hyperglycemia as diabetes results in an impaired prognosis in ST-elevation myocardial infarction (STEMI) patients. It is unknown whether there is a different prevalence of diabetes and acute hyperglycemia in men and women within age-groups.MethodsBetween 2004 and 2010, 4640 consecutive patients (28% women) with STEMI, were referred for primary PCI. Patients were stratified into two age groups, < 65 years (2447 patients) and ≥65 years (2193 patients). Separate analyses were performed in 3901 patients without diabetes. Diabetes was defined as known diabetes or HbA1c ≥6.5 mmol/l at admission.ResultsThe prevalence of diabetes was comparable between women and men in the younger age group (14% vs 12%, p = 0.52), whereas in the older age group diabetes was more prevalent in women (25% vs 17% p < 0.001). In patients without diabetes, admission glucose was comparable between both genders in younger patients (8.1 ± 2.0 mmol/l vs 8.0 ± 2.2 mmol/l p = 0.36), but in older patients admission glucose was higher in women than in men (8.7 ± 2.1 mmol/l vs 8.4 ± 2.1 mmol/l p = 0.028). After multivariable analyses, the occurrence of increased admission glucose was comparable between men and women in the younger age group (OR 1.1, 95%CI 0.9-1.5), but increased in women in the older age group (OR 1.3, 95% CI 1.1-1.7). Both diabetes and hyperglycemia were associated with a higher one-year mortality in both men and women.ConclusionsThe differences between men and women in hyperglycemia and diabetes in patients with STEMI are age dependent and can only be observed in older patients. This may have implications for medical treatment and should be investigated further.

Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

“…The 13 trials included in the meta-analysis were summarized in Table 1 . Seven of the selected cohort studies [ 8 , 13 – 18 ] reported both the early and late outcome events, whereas 5 studies [ 19 – 23 ] only reported the early outcome events and one study [ 24 ] only report the late outcome event. Within the 13 trials, the mean age for non-diabetic participants ranged from 55 to 65 years, and the proportion of men in majority of the studies ranged from 68% to 88%, while 1 study reported mortalities stratified by sex [ 24 ].…”

Prognostic Value of Systemic Immune-Inflammation Index and NT-proBNP in Patients with Acute ST-Elevation Myocardial Infarction

“…Moreover, it is common among the middle-aged and elderly individuals. 17 In recent years, STEMI incidence and mortality have been increasing year by year. Recently, it is not unusual for many young patients to have an acute coronary syndrome.…”

Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry

“… 36 In addition, studies on this issue conducted in elderly patients with AMI are scarce. 37 For example, a meta-analysis including six cohort studies reported that elevated admission glucose (≥6.1–11.1 mmol/L) was significantly associated with short-term mortality in patients with STEMI without diabetes (RR 4.38; 95% CI 3.23 to 5.94). 38 In another study conducted in patients with NSTEMI undergoing PCI, admission blood glucose was a predictor of 30-day major adverse cardiovascular events (MACE), irrespective of diabetes status.…”