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. 2024 May 28;21(5):523-533.
doi: 10.26599/1671-5411.2024.05.008.

The effect of fasting plasma glucose on in-hospital mortality after acute myocardial infarction in patients with and without diabetes: findings from a prospective, nationwide, and multicenter registry

Rui Fu  1 , Ying-Xuan Zhu  2 , Kong-Yong Cui  1 , Jin-Gang Yang  3 , Hai-Yan Xu  3 , Dong Yin  1 , Wei-Hua Song  1 , Hong-Jian Wang  1 , Cheng-Gang Zhu  1 , Lei Feng  1 , Wei Wu  4 , Kai-Hong Chen  5 , Yan-Yan Zhao  2 , Ye Lu  2 , Ke-Fei Dou  1 , Yue-Jin Yang  3
Affiliations

The effect of fasting plasma glucose on in-hospital mortality after acute myocardial infarction in patients with and without diabetes: findings from a prospective, nationwide, and multicenter registry

Rui Fu et al. J Geriatr Cardiol. .

Abstract

Objectives: To evaluate the predictive value of fasting plasma glucose (FPG) for in-hospital mortality in patients with acute myocardial infarction (AMI) with different glucose metabolism status.

Methods: We selected 5,308 participants with AMI from the prospective, nationwide, multicenter CAMI registry, of which 2,081 were diabetic and 3,227 were nondiabetic. Patients were divided into high FPG and low FPG groups according to the optimal cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts, respectively. The primary endpoint was in-hospital mortality.

Results: Overall, 94 diabetic patients (4.5%) and 131 nondiabetic patients (4.1%) died during hospitalization, and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L, respectively. Compared with individuals who had low FPG, those with high FPG were significantly associated with higher in-hospital mortality in diabetic cohort (10.1% vs. 2.8%; odds ratio [OR] = 3.862, 95% confidence interval [CI]: 2.542-5.869) and nondiabetic cohort (7.4% vs. 1.7%; HR = 4.542, 95%CI: 3.041-6.782). After adjusting the potential confounders, this significant association was not changed. Furthermore, FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic status. Adding FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic cohorts.

Conclusions: This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mortality in AMI patients with and without diabetes. FPG might be useful to stratify patients with AMI.

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Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
The receiver operating characteristic curve of fasting plasma glucose to predict in-hospital mortality in patients with acute myocardial infarction.
Figure 3
Figure 3
Subgroup analysis for in-hospital mortality in patients (A) with diabetes and (B) without diabetes.
See this image and copyright information in PMC

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References

    1. Monnier L, Mas E, Ginet C, et al Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006;295:1681–1687. doi: 10.1001/jama.295.14.1681. - DOI - PubMed
    1. Baranyai T, Nagy CT, Koncsos G, et al Acute hyperglycemia abolishes cardioprotection by remote ischemic perconditioning. Cardiovasc Diabetol. 2015;14:151. doi: 10.1186/s12933-015-0313-1. - DOI - PMC - PubMed
    1. Iwakura K, Ito H, Ikushima M, et al Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction. J Am Coll Cardiol. 2003;41:1–7. - PubMed
    1. Timmer JR, Ottervanger JP, de Boer MJ, et al Hyperglycemia is an important predictor of impaired coronary flow before reperfusion therapy in ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2005;45:999–1002. doi: 10.1016/j.jacc.2004.12.050. - DOI - PubMed
    1. Planer D, Witzenbichler B, Guagliumi G, et al Impact of hyperglycemia in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: the HORIZONS-AMI trial. Int J Cardiol. 2013;167:2572–2579. doi: 10.1016/j.ijcard.2012.06.054. - DOI - PubMed

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