The association between hyperglycaemia on admission and 180-day mortality in acute myocardial infarction patients with and without diabetes

  1. T. Ainla1,2,*,
  2. A. Baburin3,4,
  3. R. Teesalu1,2,
  4. M. Rahu3,4

Article first published online: 31 MAR 2005

DOI: 10.1111/j.1464-5491.2005.01625.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 22, Issue 10, pages 1321–1325, October 2005

Additional Information

How to Cite

Ainla, T., Baburin, A., Teesalu, R. and Rahu, M. (2005), The association between hyperglycaemia on admission and 180-day mortality in acute myocardial infarction patients with and without diabetes. Diabetic Medicine, 22: 1321–1325. doi: 10.1111/j.1464-5491.2005.01625.x

Author Information

  1. 1

    Department of Cardiology, University of Tartu, Tartu,

  2. 2

    Department of Cardiology, Tartu University Clinics, Tartu,

  3. 3

    Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn and

  4. 4

    Estonian Centre of Excellence in Behavioural and Health Sciences, Tallinn, Estonia

*Dr Tiia Ainla MD, Department of Cardiology, University of Tartu, Puusepa 8, 51014 Tartu, Estonia. E-mail: Tiia.Ainla@kliinikum.ee

Publication History

  1. Issue published online: 13 SEP 2005
  2. Article first published online: 31 MAR 2005
  3. Accepted 15 November 2004

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Keywords:

  • acute myocardial infarction;
  • diabetes;
  • hyperglycaemia;
  • mortality

Abstract

Aim  To evaluate the association between hyperglycaemia on admission, previously known diabetes and 180-day mortality in acute myocardial infarction (AMI) patients.

Methods  The study population consisted of 779 consecutive AMI patients from the Myocardial Infarction Registry in Estonia who had an admission venous plasma glucose level recorded and who were admitted to the Tartu University Clinics within a period of 2 years. Logistic regression analysis was used to estimate crude and adjusted odds ratios (OR) with 95% confidence interval (95% CI).

Results  In patients without a history of diabetes, glucose level was ≤ 11.0 mmol/l in 556 patients (group 1) and > 11.0 mmol/l in 109 patients (group 2). Of those with diabetes, glucose level was ≤ 11.0 mmol/l in 30 patients (group 3) and > 11.0 mmol/l in 84 patients (group 4). Non-diabetic hyperglycaemic patients underwent more resuscitations outside of hospital (group 2, 31.2% vs. group 1, 2.0% vs. group 3, 6.7% vs. group 4, 6.0%, P < 0.0001) and had a higher 180-day mortality compared with other groups (group 2, 47.7% vs. group 1, 14.1% vs. group 3, 26. 7% vs. group 4, 29.8%, P < 0.0001). After adjustment for potentially confounding factors, hyperglycaemic non-diabetic (OR 4.35, 95% CI 1.79–10.59), but not diabetic (OR 1.79, 95% CI 0.62–5.15) status, remained an independent predictor of 180-day mortality.

Conclusions  AMI patients with hyperglycaemia on admission, independent of a history of diabetes, represent a high-risk population for 180-day mortality. The worst outcome occurs in non-diabetic hyperglycaemic patients. Further studies are warranted to clarify the questions of hyperglycaemia treatment in AMI patients.

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