Endocrine Abstracts

High admission plasma glucose (APG) levels after ST-segment elevation acute myocardial infarction (STEMI) are common and associated with an increased risk of death in subjects with and without known diabetes.

Aim: The aim of this study is to analyse the short and long term prognostic significance of APG in patients with STEMI with and without diabetes.

Material and methods: This study included all patients registered in Coronary Unit, Department of Cardiology at Internal Clinic, Clinical Center Kragujevac from January, the 1st 2007., to June, the 30th 2007. Patient survival was measured on 28 days and one year after admission. Diabetes mellitus was defined as the use of insulin or glucose-lowering medication on admission, or a diet for diabetes documented in medical history.

Results: We studied 115 patients admitted consecutively with STEMI. The majority of patients in the study were males (69.6%).The mean age of patients was 64.25±10.69 years. At the time of hospital admission average plasma glucose was 8.77±2.54 mmol/l. Average APG is statistically significantly higher in patients who died one month after STEMI than who survived (10.1±2.85 vs 8.45±2.37 mmol/l, P=0.006). Average APG is statistically significantly higher in patients who died one year after STEMI than who survive (9.4±2.37 vs 8.42±2.57 mmol/l, P=0.047). Total mortality of STEMI (one-month survival) pts is 19.1%. Total mortality of STEMI (one-year survival) pts is 35.6%. There is no statistically significance in average APG in diabetic patients with STEMI who died after one month and who survived (10.09±2.68 vs 10.0±2.51 mmol/l, P=0.657), as well as those who died after one year and who survived (10.1±1.92 vs 10.09±2.8 mmol/l, P=0.996). But, there is statistically significance in average APG in nondiabetic patients with STEMI who died after one month and who survived (9.97±2.97 vs 7.91±2.08 mmol/l, P=0.001), as well as those who died after one year and who survived(9.17±2.49 vs 7.84±2.24 mmol/l, P=0.013).

Conclusion: This study demonstrates that high admission plasma glucose level is common in patients with STEMI and is associated with high risk of mortality among patients with or without diabetes mellitus. Our study showed that nondiabetic patients with high admission plasma glucose have higher risk of mortality than patients with a previous known history of diabetes mellitus.