Effects of glucose abnormalities on in-hospital outcome after coronary intervention for acute myocardial infarction
Effects of glucose abnormalities on in-hospital outcome after coronary intervention for acute myocardial infarction
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DOI：
10.1253/circj.69.375
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发表时间：
2005-04-01
影响因子：
3.3
通讯作者：
Ogawa, H
中科院分区：
文献类型：
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作者：
Kosuge, M;Kimura, K;Ogawa, H
背景：葡萄糖异常对经皮冠状动脉介入治疗（PCI）后预后的影响尚不清楚。我们研究了急性心肌梗死（AMI）患者接受PCI治疗时血糖异常与住院预后之间的关系。方法与结果将849例症状出现后12h内入院并行急诊PCI的AMI患者根据入院时是否存在高血糖进行分类，以入院时血糖水平为> - 11mmol /L及是否有糖尿病史为标准：1组（n=504），非糖尿病患者，入院时无高血糖；第二组（n=111），入院时无高血糖的糖尿病患者；第三组（n=87），入院时有高血糖的非糖尿病患者；4组（n=147）为入院时高血糖的糖尿病患者。1、2、3、4组住院死亡率分别为2.6、2.7、11.5、8.8% （p < 0.01）。多因素分析显示，与1组患者相比，2、3、4组患者住院死亡率的优势比（95%可信区间）分别为0.80 （0.24 ~ 2.60,p=0.708）、2.29 （1.10 ~ 5.49,p=0.039）、2.14 （1.14 ~ 4.69,p=0.048）。结论：接受PCI治疗的AMI住院患者，入院时高血糖，无论是否存在糖尿病，都与住院死亡率增加相关，而没有入院时高血糖的糖尿病则与此无关。
Background The effects of glucose abnormalities on outcomes after percutaneous coronary intervention (PCI) remain unclear. We examined the association between glucose abnormalities and in-hospital outcome in patients undergoing PCI for acute myocardial infarction (AMI).Methods and Results A total of 849 patients with AMI who were admitted within 12h after symptom onset and underwent emergency PCI were classified according to the presence or absence of admission hyperglycemia, defined as a blood glucose level on admission of > 11 mmol/L and whether they had a history of diabetes mellitus: group 1 (n=504), non-diabetic patients without admission hyperglycemia; group 2 (n=111), diabetic patients without admission hyperglycemia; group 3 (n=87), non-diabetic patients with admission hyperglycemia; and group 4 (n=147), diabetic patients with admission hyperglycemia. Among groups 1, 2, 3 and 4, in-hospital mortality was 2.6, 2.7, 11.5 and 8.8%, respectively (p < 0.01). Multivariate analysis showed that compared with group 1 patients, the odds ratio (95%confidence interval) for in-hospital mortality among those in groups 2, 3, and 4 were 0.80 (0.24-2.60, p=0.708), 2.29 (1.10-5.49, p=0.039), and 2.14 (1.14-4.69, p=0.048), respectively.Conclusions In-patients undergoing PCI for AMI, admission hyperglycemia, irrespective of the presence or absence of diabetes, is associated with increased in-hospital mortality, whereas diabetes without admission hyperlycemia is not.