Coronary artery diseaseImpact of Admission Hyperglycemia and Diabetes Mellitus on Short- and Long-Term Mortality After Acute Myocardial Infarction in the Coronary Intervention Era
Section snippets
Methods
From January 1996 to December 2003, a total of 802 consecutive patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain at Hiroshima City Hospital, Hiroshima, Japan. AMI was diagnosed as chest pain consistent with ongoing myocardial ischemia persisting >30 minutes with concomitant electrocardiographic changes. Serum creatine kinase was measured every 3 hours for at least 24 hours, and peak creatine kinase had to be more than twice the normal upper limit.
Results
There were 261 patients (32%) with admission hyperglycemia. Baseline clinical and angiographic characteristics of patients with and without admission hyperglycemia are listed in Table 1. Baseline characteristics of diabetic and nondiabetic patients are listed in Table 2. There were 212 patients (26%) with diabetes. Ninety-seven patients (46%) were treated with diet only; 94 patients (44%), with oral hypoglycemic drugs; and 21 patients (10%), with insulin. Peak creatine kinase was obtained in
Discussion
This study showed that both admission hyperglycemia and diabetes increased 3-year mortality after AMI in the contemporary PCI era. However, influences of admission hyperglycemia and diabetes on mortality were different and time dependent. Admission hyperglycemia increased mortality markedly during the first 30 days, then mortality leveled off in both diabetic and nondiabetic patients. In patients without admission hyperglycemia, 30-day mortality was low regardless of diabetic status. However,
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