Impaired glucose metabolism predicts mortality after a myocardial infarction

Bolk, J.H.; Ploeg, T. van der; Cornel, Jan H.; Arnold, Alfred; Sepers, Jan M.; Umans, Victor

doi:10.1016/s0167-5273(01)00422-3

Cited by 193 publications

(106 citation statements)

References 31 publications

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“…When diabetes was present and admission glucose was Ն180 mg/dl (10 mmol/l), risk of death was moderately increased (1.7, 1.2-2.4) compared with patients who had diabetes but no hyperglycemia on admission. Bolk et al (193) analyzed admission blood glucose values in 336 prospective, consecutive patients with AMI with average follow-up to 14.2 months. Twelve percent of this cohort had previously diagnosed diabetes.…”

Section: Cvd and Critical Carementioning

confidence: 99%

Management of Diabetes and Hyperglycemia in Hospitals

et al. 2004

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Section: Cvd and Critical Carementioning

confidence: 99%

Management of Diabetes and Hyperglycemia in Hospitals

et al. 2004

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“…[9][10][11][12][13][14][15][16][17]19 Admission hyperglycaemia is an even stronger predictor for mortality in patients without a medical history of diabetes. 9,13,19 However, there is little information about differences in outcome between men and women with hyperglycaemia on admission for ACS/AMI.…”

Section: Introductionmentioning

confidence: 99%

Admission glycaemia and outcome in patients with acute coronary syndrome

Müdespacher

Radovanovic

Camenzind

et al. 2007

Diabetes and Vascular Disease Research

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Some studies of patients with acute myocardial infarction have reported that hyperglycaemia at admission may be associated with a worse outcome. This study sought to evaluate the association of blood glucose at admission with the outcome of unselected patients with acute coronary syndrome (ACS). Using the Acute Myocardial Infarction and unstable angina in Switzerland (AMIS Plus) registry, ACS patients were stratified according to their blood glucose on admission: group 1: 2.80-6.99 mmol/L, group 2: 7.00-11.09 mmol/L and group 3: > 11.10 mmol/L. Odds ratios for in-hospital mortality were calculated using logistic regression models. Of 2,786 patients, 73% were male and 21% were known to have diabetes. In-hospital mortality increased from 3% in group 1 to 7% in group 2 and to 15% in group 3. Higher glucose levels were associated with larger enzymatic infarct sizes (p<0.001) and had a weak negative correlation with angiographic or echographic left ventricular ejection fraction. High admission glycaemia in ACS patients remains a significant independent predictor of in-hospital mortality (adjusted OR 1.08; 95% confidence intervals [CI] 1.05-1.14, p<0.001) per mmol/L. The OR for in-hospital mortality was 1.04 (95% CI 0.99-1.1; p=0.140) per mmol/L for patients with diabetes but 1.21 (95% CI 112-1.30; p<0.001) per mmol/L for non-diabetic patients. In conclusion, elevated glucose level in ACS patients on admission is a significant independent predictor of in-hospital mortality and is even more important for patients who do not have known diabetes. Using the Acute Myocardial Infarction and unstable angina in Switzerland (AMIS Plus) registry, ACS patients were stratified according to their blood glucose on admission: group 1: 2.80-6.99 mmol/L, group 2: 7.00-11.09 mmol/L and group 3: > 11.10 mmol/L. Odds ratios for in-hospital mortality were calculated using logistic regression models.Of 2,786 patients, 73% were male and 21% were known to have diabetes. In-hospital mortality increased from 3% in group 1 to 7% in group 2 and to 15% in group 3. Higher glucose levels were associated with larger enzymatic infarct sizes (p<0.001) and had a weak negative correlation with angiographic or echographic left ventricular ejection fraction. High admission glycaemia in ACS patients remains a significant independent predictor of in-hospital mortality (adjusted OR 1.08; 95% confidence intervals [CI] 1.05-1.14, p<0.001) per mmol/L. The OR for in-hospital mortality was 1.04 (95% CI 0.99-1.1; p=0.140) per mmol/L for patients with diabetes but 1.21 (95% CI 112-1.30; p<0.001) per mmol/L for non-diabetic patients.In conclusion, elevated glucose level in ACS patients on admission is a significant independent predictor of inhospital mortality and is even more important for patients who do not have known diabetes.

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“…Although a tight control of blood glucose has been considered to decrease mortality in critically ill ICU patients, this approach brings the risk of severe hypoglycemia which may also be life-threatening for some patients. The studies that have been performed on coronary ICU patients, among the cases with acute myocardial infarction, have demonstrated that intensive insulin treatment aiming tight glucose control is capable of increasing mortality (21)(22)(23)(24). The NICE-SUGAR study, which has compared the effects of tight glycemic control (PG = 81-108 mg/dL) with conventional control (PG < 180mg/dL), among the critically ill patients, has clearly shown that tight control leads to higher life-threatening hypoglycemia and mortality rates.…”

Section: The Treatment Of Hyperglycemia In General Icusmentioning

confidence: 99%

Hyperglycemia in Hospital: Diagnosis, Classification, Clinical Implications and Treatment

Bağır¹,

Ertörer²

2017

Turk J Endocrinol Metab

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H Hy yp pe er rg gl ly yc ce em mi ia a i in n H Ho os sp pi it ta al l: : D Di ia ag gn no os si is s, , C Cl la as ss si i c ca at ti io on n, , C Cl li in ni ic ca al l I Im mp pl li ic ca at ti io on ns s a an nd d T Tr re ea at tm me en nt t H Ha as st ta an ne ed de e Y Ya at ta an n H Ha as st ta ad da a H Hi ip pe er rg gl li is se em mi i: : T Ta an nı ı, , S Sı ın nı ı a am ma a, , K Kl li in ni ik k Ö Ön ne em mi i v ve e T Te ed da av vi is si i Hyperglycemia is a well-recognized risk factor for hospital-related complications, prolonged stay in the hospital and even mortality. The patients with in-hospital hyperglycemia may be categorized into three groups: i) Patients who have been diagnosed as having diabetes mellitus (DM) before admission; ii) Patients with newly diagnosed DM; and iii) Patients with stress hyperglycemia. The release of stress hormones, such as cortisol, catecholamines, glucagon, growth hormone and the related acceleration in gluconeogenesis and glycogenolysis, medications used for the treatment of primary diseases, such as glucocorticoids and vasopressors, are all claimed to be responsible for the development of in-hospital hyperglycemia. Glucose normalization with insulin therapy has been demonstrated to signicantly decrease the morbidity and mortality in all the three groups. Therefore, it is recommended to monitor blood glucose levels for all hospitalized patients irrespective of the accompanying DM diagnosis. Keywords: Hyperglycemia; hospital; stress Hiperglisemi; hastane ilişkili komplikasyon sıklığını, hastanede kalış süresini ve mortaliteyi artırmaktadır. Hastanede yatan hastalarda, genel olarak üç farklı hiperglisemi grubu ile karşılaşılmaktadır: i) Yatış öncesinde diyabet tanısı olanlar, ii) İlk kez diyabet tanısı alan hastalar, iii) Stres hiperglisemisi olan hastalar. Hastanede yatan hastalarda, stres hormonlarının salınımının artışı (kortizol, katekolamin, glukagon, büyüme hormonu gibi), artmış glukoneogenez ve glukojenoliz, tedavi amaçlı glukokortikoit ve vazopresör ajan kullanımı gibi nedenler hiperglisemi gelişiminden sorumludur. Her üç grupta da insülin tedavisi ile glukoz normalizasyonu sağlanması ile mortalite ve morbidite de belirgin azalma sağlandığı gösterilmiştir. Bu nedenle, diyabet tanısı varlığından bağımsız olarak, hastanede yatan bütün hastaların kan glukoz takipleri yapılmalıdır.

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Impaired glucose metabolism predicts mortality after a myocardial infarction

Cited by 193 publications

References 31 publications

Management of Diabetes and Hyperglycemia in Hospitals

Management of Diabetes and Hyperglycemia in Hospitals

Admission glycaemia and outcome in patients with acute coronary syndrome

Hyperglycemia in Hospital: Diagnosis, Classification, Clinical Implications and Treatment

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