Admission hyperglycemia predicts poorer short- and long-term outcomes after primary percutaneous coronary intervention for ST-elevation myocardial infarction.
Admission hyperglycemia predicts poorer short- and long-term outcomes after primary percutaneous coronary intervention for ST-elevation myocardial infarction.
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DOI：
10.1111/jdi.12113
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发表时间：
2014-02-12
影响因子：
3.2
通讯作者：
Shyu KG
中科院分区：
文献类型：
--
作者：
Chen PC;Chua SK;Hung HF;Huang CY;Lin CM;Lai SM;Chen YL;Cheng JJ;Chiu CZ;Lee SH;Lo HM;Shyu KG
入院时高血糖与心肌梗死患者预后不良相关。本研究评价了接受直接经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者入院时血糖水平与其他临床变量之间的关系。根据入院时血糖水平<100、100-139、140-189、190-249和≥250 mg/dL，将959例接受直接PCI的连续STEMI患者分为5组。比较了他们的短期和长期结果。入院时血糖水平越高，住院时发病率和死亡率、随访时的总体死亡率以及需要入院或导致随访时死亡的再梗死或心力衰竭的发生率显著越高。比值比入院时血糖水平≥190 mg/dL的患者与入院时血糖水平<190 mg/dL的患者相比，住院时发病率、住院时死亡率、随访时死亡率和再梗死或心力衰竭或随访时死亡率（95%置信区间）分别为2.12（1.3-3.4，P = 0.001）、2.74（1.4-5.5，P = 0.004）、2.52（1.2-5.1，P = 0.01）和1.70（1.03-2.8，P = 0.04）。入院时血糖水平≥250 mg/dL的既往非糖尿病患者的院内发病率或死亡率显著较高（44 vs 70%，P = 0. 03）。在100-139 mg/dL（8 vs 27%，P = 0.04）和140-189 mg/dL（11 vs 26%，P = 0.02）组中，随访时已知糖尿病患者的再梗死、心力衰竭或死亡率较高。入院时高血糖，尤其是血糖水平≥190 mg/dL时，是行直接PCI的STEMI患者预后不良的预测因子。
Admission hyperglycemia is associated with poor outcome in patients with myocardial infarction. The present study evaluated the relationship between admission glucose level and other clinical variables in patients with ST‐elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The 959 consecutive STEMI patients undergoing primary PCI were divided into five groups based on admission glucose levels of <100, 100–139, 140–189, 190–249 and ≥250 mg/dL. Their short‐ and long‐term outcomes were compared. Higher admission glucose levels were associated with significantly higher in‐hospital morbidity and mortality, the overall mortality rate at follow up, and the incidence of reinfarction or heart failure requiring admission or leading to mortality at follow up. The odds ratios (95% confidence interval) for in‐hospital morbidity, in‐hospital mortality, mortality at follow up and re‐infarction or heart failure or mortality at follow up of patients with admission glucose levels ≥190 mg/dL, compared with those with admission glucose levels <190 mg/dL, were 2.12 (1.3–3.4, P = 0.001), 2.74 (1.4–5.5, P = 0.004), 2.52 (1.2–5.1, P = 0.01) and 1.70 (1.03–2.8, P = 0.04), respectively. Previously non‐diabetic patients with admission glucose levels ≥250 mg/dL had significantly higher in‐hospital morbidity or mortality (44 vs 70%, P = 0.03). Known diabetic patients had higher rates of reinfarction, heart failure or mortality at follow up in the 100–139 mg/dL (8 vs 27%, P = 0.04) and 140–189 mg/dL (11 vs 26%, P = 0.02) groups. Admission hyperglycemia, especially at glucose levels ≥190 mg/dL, is a predictor of poor prognosis in STEMI patients undergoing primary PCI.
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影响因子：
39.3
作者：
Busk, Martin;Maeng, Michael;Andersen, Henning R.
通讯作者：
Andersen, Henning R.
影响因子：
1.6
作者：
Ergelen, Mehmet;Uyarel, Huseyin;Ilhan, Erkan
通讯作者：
Ilhan, Erkan
影响因子：
2.5
作者：
Nakamura, Tomohiro;Ako, Junya;Momomura, Shinichi
通讯作者：
Momomura, Shinichi
影响因子：
5.1
作者：
Cruz-Gonzalez, Ignacio;Chia, Stanley;Jang, Ik-Kyung
通讯作者：
Jang, Ik-Kyung
影响因子：
3.3
作者：
Kosuge, M;Kimura, K;Ogawa, H
通讯作者：
Ogawa, H