Impact of newly diagnosed abnormal glucose tolerance on long-term prognosis in patients with acute myocardial infarction

Circ J. 2007 Jun;71(6):834-41. doi: 10.1253/circj.71.834.


Background: Newly-diagnosed diabetes mellitus (DM) and impaired glucose tolerance are common among patients with acute myocardial infarction (AMI). However, its significance on long-term clinical outcomes in those patients remains unclear. The present study was designed to determine whether such abnormalities after AMI affect long-term clinical outcomes.

Methods and results: Two-hundred and seventy-five AMI patients were prospectively enrolled. Eighty-five had diagnosed DM, while the other 190 did not. According to oral glucose tolerance tests at discharge, non-DM patients were divided into 2 groups: 78 patients with normal glucose tolerance and 112 patients with abnormal glucose tolerance. Patients were followed until they reached the primary endpoint: cardiovascular death or unplanned hospitalization due to major adverse cardiovascular events. The median follow-up period was 5.3 years. Kaplan-Meier survival curves for the abnormal glucose tolerance group were poorer than for normal glucose tolerance, and were equivalent to the pre-diagnosed DM group in prognosis (p<0.0005). Glucometabolic status was the strongest predictor for future cardiovascular events (hazard ratio to normal glucose tolerance; 2.65; confidence interval: 1.37-5.15; p=0.004 in abnormal glucose tolerance and 3.27:1.68-6.38; p=0.0005 in DM).

Conclusions: Abnormal glucose tolerance in patients with AMI is a major risk factor for future cardiovascular events and may critically distinguish high-risk individuals.

MeSH terms

  • Acute Disease
  • Aged
  • Blood Glucose / analysis*
  • Death*
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / etiology
  • Diabetes Mellitus / mortality
  • Fasting / blood
  • Female
  • Glucose Tolerance Test
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality
  • Prognosis
  • Risk Factors
  • Time Factors


  • Blood Glucose