Revista chilena de cardiología
versión ISSN 0718-8560
CARDENAS, Felipe; GONZALEZ, Nicolás; GARCIA, Daniel y ASTUDILLO, Carlos. Relationship between hyperglycemia on admission and prognosis in nondiabetic patients with acute myocardial infarction not undergoing reperfusion therapy. Rev Chil Cardiol [online]. 2012, vol.31, n.1, pp. 24-28. ISSN 0718-8560. doi: 10.4067/S0718-85602012000100003.
Background: Only in recent years attention has been paid to the relationship between hyperglycemia and the increased morbidity and mortality of acute myo-cardial infarction. Numerous studies have described this association in patients with type 2 diabetes mellitus. However, there are few studies in patients without previously diagnosed type 2 diabetes. Aim: to determine the relationship between hyper-glycemia on admission (IH) and prognosis in patients admitted with acute ST elevation myocardial infarction who had no history of DM2 and did not undergo reper-fusion therapy (primary angioplasty and/or thrombolysis). Method: We performed a retrospective study that included a cohort of 230 patients admitted to the emergency unit of the Hospital Carlos Van Buren with acute ST elevation myocardial infarction from 2008 through 2009 who had a blood glucose test done at admission. Patients were divided into two groups according to whether or not they were hyperglycemic. We used a composite outcome that included death, re-infarction, coronary cause of rehospitalization, need for coronary angiography and revascularization. We also evaluated each of its components separately. Results: The composite event rate was 31.9% in patients with IH vs 27.6% in patients without IH (p=0.05). Respective mortality rates were 11% and 0.8% (p<0.001), with a RR of 13.3 (CI 1.7 - 100.7) and LR 12.7. Re infarction occurred in 4 patients, all of them with IH (p=0.034, LR 6) Conclusion: Hyperglycemia on admission was found to be an important marker of short term morbidity and mortality in patients with ST elevation myocardial infarction and no prior diagnosis of Diabetes.
Palabras clave : Hyperglycemia; prognosis; myocardial infarction.