Glucose dysregulation in nondiabetic patients with ST-elevation myocardial infarction: acute and chronic glucose dysregulation in STEMI

S. Rasoul, J. P. Ottervanger*, H. J. G. Bilo, J. R. Timmer, A. W. J. van't Hof, L. D. Dikkeschei, J. C. A. Hoorntje, M. J. de Boer, F. Zijlstra, Jan Hendrik Everwijn Dambrink

*Corresponding author for this work

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Background: Admission hyperglycaemia is associated with an increased risk of mortality after myocardial infarction. Whether long-term glucose dysregulation (assessed by HbAic) is more important than acute hyperglycaemia is unknown. We evaluated the prognostic value of admission glucose and HbAic levels in nondiabetic patients with ST-segment elevation acute myocardial infarction (STEMI). Methods: In 504 unselected, consecutive patients with STEMI, glucose and HbAic levels were measured on admission. Glucose was categorised as = 11.1 mmol/l (n=82). HbAic levels were categorised as = 6.0% (n=88). Mean follow-up was 1.6 +/- 0.6 years. Results: Patients with hyperglycaemia on admission were comparable with those with normoglycaernia. However, patients with HbAic >= 6.0%, as compared with those with HbAic = 11.1 mmol/l) was 4% and 19% (p= 6%) was 5% and 12% (p=0.03)After multivariable analyses, admission glucose (OR 4.91, 95% CI 2.03 to 11.9, p<0.001) but not HbAic (OR 1.33, 95% CI 0.48 to 3.71, p=0.58) was significantly associated with 30-day mortality. Among 30-day survivors, neither admission glucose nor HbAic were predictors of long-term mortality. Conclusion: Elevated admission glucose is an important predictor of 30-day outcome after STEMI, while prior long-term glucose dysregulation is a covariate of other high-risk clinical characteristics. Among 30-day survivors, neither admission blood glucose nor HbAic were predictors of long-term outcome.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalNetherlands Journal of Medicine
Issue number3
Publication statusPublished - Mar-2007


  • ST-elevation acute myocardial infarction
  • admission glucose
  • HbAic
  • outcome
  • RISK

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