Effect of Admission Hyperglycemia on Mortality in Diabetic and Non-diabetic Geriatric Patients with Non-ST-segment Elevation Myocardial Infarction

Abstract

Objectives: High level of admission plasma glucose (APG) in myocardial infarction is associated with an increased risk of death in previous studies; however, most studies that evaluated this relationship were conducted before the guideline based definition of hyperglycemia. This study was designed to assess the prognostic significance of APG and admission hyperglycemia in patients with and without diabetes mellitus (DM). Materials and Methods: Five hundred and twenty-seven geriatric patients with non-ST segment elevation myocardial infarction (NSTEMI) were enrolled in the study. Patients were divided into four groups according to APG and DM status: those with DM, those with APG <144 mg/dL were named group 1, and those with APG ?144 mg/dL were named group 2. Those without DM, those with APG <180 mg/dL were called group 3, and those with APG? 180 mg/dL were named group 4. Results: Hyperglycemia was common in diabetic and nondiabetic patients threatening 29% of the study population. Patients without hyperglycemia (Groups 1 and 3) had the least mortality rates in one-month follow-up. In one-year follow up, the patients with hyperglycemia (Group 2 and 4) had higher mortality rates (22.6% and 23.3%, respectively) than those with no-hyperglycemia groups. In regression analysis, hyperglycemia was independently associated with one-month and one-year mortality. In receiver operating characteristics curve analysis, the discriminative value of APG for one-month and one-year mortality was good in the groups. Conclusion: APG may be used to predict one-month and one-year death irrespective of DM status. Therefore, DM and admission hyperglycemia could not be considered and treated as similar situations.