Prognostic importance of admission versus persistent glycemia in acute coronary syndrome.
Diabetes Metab Syndr
; 7(1): 42-7, 2013.
Article
em En
| MEDLINE
| ID: mdl-23517796
ABSTRACT
BACKGROUND:
Whether persistent hyperglycemia (PG) during hospitalisation has a greater impact on adverse outcomes in acute myocardial infarction (AMI) than a single random glucose measurement is not well defined.AIMS:
To find out the association of admission glycemia (AG) VS PG on outcomes in patients of ACS. STUDY DESIGN ANDMETHODS:
Prospective, cohort, hospital-based. We evaluated 200 patients of ACS for admission and in-hospital glycemia and their impacts on outcomes. AG was defined as a plasma glucose >198 mg/dl and PG as a random glucose >140 mg/dl at any point during hospitalisation. Demographic and biochemistry including risk factors recorded. A multiple regression was done to evaluate association of various parameters with worse prognosis.RESULTS:
Of the 200 patients evaluated, 35 (17.5%) presented with AG. 31 (15.5%) had PG. Males were predominant and 47 (23%) previously known diabetic patients. 62 (31%) had unstable angina, 52 (26%) NSTEMI and 86 (43%) STEMI, between PG and LEF, higher troponin levels and in-hospital mortality and between LEF and age (p<0.001), serum creatinine (p 0.023) and mean in-hospital glucose (p 0.005). F-indices were compared with AG for their ability to discriminate hospitalization survivors from non-survivors. All average glucose metrics performed better than AG. The ability of these models improved as the time window increased (F-indices for admission, mean 24h, 48 h and 72 h were 2.51, 12.05, 8.3 and 5.72, respectively).CONCLUSION:
The present study demonstrates that PG is a better discriminator of prognosis than AG in patients of ACS.
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Base de dados:
MEDLINE
Assunto principal:
Glicemia
/
Hemoglobinas Glicadas
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Diabetes Mellitus Tipo 2
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Síndrome Coronariana Aguda
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Hospitalização
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Hiperglicemia
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article