Impact of stress hyperglycemia on in-hospital stent thrombosis and prognosis in nondiabetic patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention

Coron Artery Dis. 2013 Aug;24(5):352-6. doi: 10.1097/MCA.0b013e328361a942.

Abstract

Objective: Stress hyperglycemia (SH) in a setting of acute myocardial infarction increases the risk of in-hospital mortality. The relationship between SH and in-hospital stent thrombosis (ST) is rare. The aim of our study was to assess the impact of SH on in-hospital ST and prognosis in nondiabetic patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (p-PCI).

Patients and methods: This study included 853 patients without diabetes mellitus with STEMI. All patients were treated with p-PCI. Blood glucose (BG) was measured on admission. The patients were divided into two groups on the basis of admission BG (SH, BG≥180 mg/dl; non-SH, BG<180 mg/dl). The two groups were compared with respect to baseline characteristics and primary endpoints.

Results: During hospitalization, all-cause mortality was 2.9%. The total incidence of ST was 1.9%. Patients with SH experienced a significantly higher incidence of mortality (P=0.045), ST (P=0.038), and composite major adverse cardiac events (MACE) (P=0.008) than patients without SH. Patients with SH extended hospital days (P<0.001). After multivariate analysis, SH was associated independently with in-hospital mortality, incidence of ST, and composite MACE.

Conclusion: In nondiabetic patients with STEMI undergoing p-PCI, the patients with SH experienced a significantly higher incidence of mortality, ST, and composite MACE.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Chi-Square Distribution
  • China / epidemiology
  • Coronary Thrombosis / epidemiology*
  • Coronary Thrombosis / mortality
  • Female
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / epidemiology*
  • Hyperglycemia / mortality
  • Incidence
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / mortality
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Stress, Physiological*
  • Time Factors
  • Treatment Outcome

Substances

  • Blood Glucose