Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease.
Mayo Clin Proc
; 88(9): 930-41, 2013 Sep.
Article
en En
| MEDLINE
| ID: mdl-24001485
ABSTRACT
OBJECTIVE:
To assess the association between fasting plasma glucose (FPG) and all-cause mortality across the spectrum of coronary artery disease (CAD). PATIENTS ANDMETHODS:
The study included 18,999 patients during a study period of April 1, 2004, through October 31, 2010. The primary end points were in-hospital and follow-up all-cause mortality. According to the quartiles of FPG levels, patients were categorized into 4 groups quartile 1, less than 5.1 mmol/L; quartile 2, 5.1 to less than 5.9 mmol/L; quartile 3, 5.9 to less than 7.5 mmol/L; and quartile 4, 7.5 mmol/L or greater. The conversion factor for units of plasma glucose is 1.00 mmol/L equals 18 mg/dL. Presented as mg/dL, the 4 quartile ranges of plasma glucose concentrations used in our data analysis are ≤90.0 mg/dL, 90.1-106.0 mg/dL, 106.1 mg/dL-135.0 mg/dL and ≥135.1 mg/dL. Quartile 1 was recognized as the lower glycemic group, quartiles 2 and 3 as the normoglycemic groups, and quartile 4 as the higher glycemic group.RESULTS:
In patients with acute myocardial infarction, all-cause mortality for the dysglycemic groups was higher than for the normoglycemic groups in-hospital mortality for quartiles 1, 2, 3, and 4 was 1.0%, 0.9%, 0.2%, and 1.5%, respectively (P=.001); follow-up mortality for quartiles 1, 2, 3, and 4 was 1.7%, 0.9%, 0.3%, and 1.8%, respectively (P<.001). In patients with stable CAD, no significant differences in mortality were found among groups. However, in patients with unstable angina pectoris, the normoglycemic groups had lower follow-up mortality and roughly equal in-hospital mortality compared with the dysglycemic groups. After adjusting for confounding factors, this observation persisted.CONCLUSION:
The association between lower FPG level and mortality differed across the spectrum of CAD. In patients with acute myocardial infarction, there was a U-shaped relationship. In patients with stable CAD or unstable angina pectoris, mildly to moderately decreasing FPG level was associated with neither higher nor lower all-cause mortality.Palabras clave
ACC/AHA; ACS; AMI; American College of Cardiology/American Heart Association; BHMS; Beijing Heart and Metabolism Survey; CAD; CCS; Canadian Cardiovascular Society; DIGAMI; DM; Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction; FPG; HR; LDL-C; LVEF; PCI; SCAD; UAP; acute coronary syndrome; acute myocardial infarction; coronary artery disease; diabetes mellitus; fasting plasma glucose; hazard ratio; left ventricular ejection fraction; low-density lipoprotein cholesterol; percutaneous coronary intervention; stable coronary artery disease; unstable angina pectoris
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
/
Enfermedad de la Arteria Coronaria
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Mayo Clin Proc
Año:
2013
Tipo del documento:
Article
País de afiliación:
China