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. 2013 Nov 15:12:171.
doi: 10.1186/1475-2840-12-171.

High admission glucose levels increase Fas apoptosis and mortality in patients with acute ST-elevation myocardial infarction: a prospective cohort study

Jing Chang, Gong Zhang, Li Zhang, Yuan-Ping Hou, Xiu-Lan Liu, Lin Zhang  1
Affiliations

High admission glucose levels increase Fas apoptosis and mortality in patients with acute ST-elevation myocardial infarction: a prospective cohort study

Jing Chang et al. Cardiovasc Diabetol. .

Abstract

Background: The presence of diabetes and plasma glucose concentration on admission are associated with adverse outcomes after an acute myocardial infarction (AMI), as high glucose can induce vascular endothelial cell apoptosis. This study explored the relative associations among admission plasma glucose level, soluble Fas (sFas) concentration, and long-term survival in patients with acute ST-elevation myocardial infarction (STEMI).

Methods: This prospective cohort study include 83 patients with acute STEMI. Based on their admission plasma glucose levels (7.8 and 11.1 mmol/L as the limits for low and high levels, respectively), patients were allocated into one of three groups: normal glucose (n = 33), median glucose (n = 24), and high glucose (n = 26). The admission plasma level of sFas was measured with a sandwich enzyme-linked immunosorbent assay (ELISA). Patients were followed up for an average of 89 ± 20 months for all causes of death and cardiovascular death.

Results: sFas levels were significantly higher in the high glucose group compared to the normal glucose group (5.87 ± 1.70 mmol/L vs. 3.07 ± 0.93 mmol/L, respectively, P < 0.05). The sFas level was positively associated with the admission plasma glucose level. The correlation coefficient (R) was 0.747, and R2 was 0.559. Mortality was significantly higher in the high glucose group compared to the normal glucose group (19.2% vs. 3.0%, respectively, P < 0.05).

Conclusions: In patients with acute STEMI, plasma glucose level was high on admission, and sFas apoptosis levels were increased. Long-term follow-up revealed that a high admission plasma glucose level was associated with higher mortality compared to a normal admission glucose level.

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Figures

Figure 1
Figure 1
Patient flow diagram. Patients with acute ST-elevation myocardial infarction were divided into three groups based on their admission plasma glucose level. Three patients were lost to follow up, and eight patients died within the follow-up period.
Figure 2
Figure 2
Correlation between the admission glucose level and the sFas level. We found that sFas levels increased in accordance with improvement in the admission glucose level. The correlation coefficient R is 0.747, the R2 is 0.559, with a regression line equation of Y = 1.225 + 0.327X (P < 0.05).
Figure 3
Figure 3
Kaplan-Meier survival curves of acute ST-elevation myocardial infarction patients with different admission plasma glucose levels. Mortality was higher in the high glucose level group than the normal glucose level group (P < 0.05).
See this image and copyright information in PMC

References

    1. Moe KT, Wong P. Current trends in diagnostic biomarkers of acute coronary syndrome. Ann Acad Med Singapore. 2010;39:210–215. - PubMed
    1. White HD, Chew DP. Acute myocardial infarction. Lancet. 2008;372:570–584. doi: 10.1016/S0140-6736(08)61237-4. - DOI - PubMed
    1. ESC Committee for Practice Guidelines (CPG) ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33:2569–2619. - PubMed
    1. Shimizu M, Fukuo K, Nagata S, Suhara T, Okuro M, Fujii K, Higashino Y, Mogi M, Hatanaka Y, Ogihara T. Increased plasma levels of the soluble form of Fas ligand in patients with acute myocardial infarction and unstable angina pectoris. J Am Coll Cardiol. 2002;39:585–590. doi: 10.1016/S0735-1097(01)01800-9. - DOI - PubMed
    1. Zhao WS, Xu L, Wang LF, Zhang L, Zhang ZY, Liu Y, Liu XL, Yang XC, Cui L, Zhang L. A 60-s postconditioning protocol by percutaneous coronary intervention inhibits myocardial apoptosis in patients with acute myocardial infarction. Apoptosis. 2009;14:1204–1211. doi: 10.1007/s10495-009-0387-x. - DOI - PubMed