Author/Authors :
Fujino، نويسنده , , Masashi and Ishihara، نويسنده , , Masaharu and Honda، نويسنده , , Satoshi and Kawakami، نويسنده , , Shoji and Yamane، نويسنده , , Takafumi and Nagai، نويسنده , , Toshiyuki and Nakao، نويسنده , , Kazuhiro and Kanaya، نويسنده , , Tomoaki and Kumasaka، نويسنده , , Leon and Asaumi، نويسنده , , Yasuhide and Arakawa، نويسنده , , Tetsuo and Tahara، نويسنده , , Yoshio and Nakanishi، نويسنده , , Michio and Noguchi، نويسنده , , Teruo and Kusano، نويسنده , , Kengo and Anzai، نويسنده , , Toshihisa and Goto، نويسنده , , Yoichi and Yasuda، نويسنده , , Satoshi and Ogawa، نويسنده , , Hisao، نويسنده ,
Abstract :
This study was undertaken to assess the impact of acute hyperglycemia (acute-HG) and chronic hyperglycemia (chronic-HG) on short-term outcomes in patients with acute myocardial infarction (AMI). This study consisted of 696 patients with AMI. Acute-HG was defined as admission plasma glucose ≥200 mg/dl and chronic-HG as hemoglobin A1c ≥6.5%. Acute-HG was associated with higher peak serum creatine kinase (4,094 ± 4,594 vs 2,526 ± 2,227 IU/L, p <0.001) and in-hospital mortality (9.8% vs 1.6%, p <0.001). On the contrary, there was no significant difference in peak creatine kinase (2,803 ± 2,661 vs 2,940 ± 3,181 IU/L, p = 0.59) and mortality (3.3 vs 3.7%, p = 0.79) between patients with chronic-HG and those without. Multivariate analysis showed that admission plasma glucose was an independent predictor of in-hospital mortality (odds ratio 1.15, 95% confidence interval 1.05 to 1.27, p <0.001), but hemoglobin A1c was not. When only patients with acute-HG were analyzed, chronic-HG was associated with a significantly smaller infarct size (3,221 ± 3,001 vs 5,904 ± 6,473 IU/L, p <0.001) and lower in-hospital mortality (5.5 vs 18.9%, p = 0.01). In conclusion, these results suggested that acute-HG, but not chronic-HG, was associated with adverse short-term outcomes after AMI. Paradoxically, in patients with acute-HG, chronic-HG might abate the adverse effects of acute-HG.
