Abstract

CARDENAS, Felipe; GONZALEZ, Nicolás; GARCIA, Daniel  and  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.  http://dx.doi.org/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.

Keywords : Hyperglycemia; prognosis; myocardial infarction.

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