Prognostic Implication of Hyperglycemia in Myocardial Infarction and Primary Angioplasty

Purpose The study assessed the relationship of admission blood glucose level to in-hospital mortality in patients presenting with an ST-segment elevation myocardial infarction and treated with primary angioplasty. Methods A total of 980 patients presenting with an ST-segment elevation myocardial infarction and treated exclusively with primary angioplasty were evaluated. Patients were divided into quartiles based on their admission blood glucose level: group 1 (≤6.6 mmol/L [≤119 mg/dL]), group 2 (6.7-7.8 mmol/L [120-140 mg/dL]), group 3 (7.9-10.0 mmol/L [141-180 mg/dL], and group 4 (≥10.1 mmol/L [≥181 mg/dL]. The primary end point was in-hospital mortality. Results The mean age of the patient cohort was 62 years, 260 (27%) of whom were female. The mean admission blood glucose level was 9.1 ± 4.4 mmol/L (164 ± 79 mg/dL). At admission, 16% of this group were known to have diabetes. The in-hospital mortality rate was 3.8% (n = 37), 5.2% in the diabetic group (n = 8) and 3.5% (n = 29) in the nondiabetic group. In-hospital mortality rates were significantly increased in patients with an elevated admission blood glucose level (P <.001). The in-hospital deaths in each admission blood glucose level quartile were 0.4% (n = 1) in group 1, 2% (n = 6) in group 2, 2% (n = 6) in group 3, and 10% (n = 24) in group 4. Conclusions In this cohort of patients who were admitted with an ST-segment elevation myocardial infarction and treated exclusively with primary angioplasty, elevated admission blood glucose level is significantly associated with an increase in in-hospital mortality.