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Elevated Admission Glucose Levels Linked to Increased Mortality After Heart Attack

Strategic Insights

— 1 min read

Research conducted at the Erasmus University Medical Center in Rotterdam, Netherlands, has found a strong association between elevated admission glucose levels and increased mortality in patients after a heart attack. The study, published in the American Journal of Cardiology, examined temporal trends in mortality after myocardial infarction from 1985 to 2008, depending on admission glucose levels.

The study included 11,324 consecutive patients admitted to the intensive coronary care unit for myocardial infarction from 1985 to 2008. Patients were categorized into normal, mild, and severe hyperglycemia groups based on admission glucose levels. The prevalence of hyperglycemia increased from 26% in the 1980s to 49% in the 2000s, primarily in patients without diabetes. The study found that compared with normal admission glucose levels, adjusted 30-day mortality was 3.6-fold greater in patients with severe hyperglycemia.

Key Takeaways:

  • The prevalence of hyperglycemia increased from 26% in the 1980s to 49% in the 2000s in patients admitted with myocardial infarction.
  • The prevalence of hyperglycemia primarily increased in patients without diabetes.
  • Elevated admission glucose levels are strongly associated with increased mortality after heart attack.
  • Compared with normal admission glucose levels, adjusted 30-day mortality was 3.6-fold greater in patients with severe hyperglycemia.
  • The association between elevated admission glucose levels and increased mortality was not dependent on diabetic status but was dependent on the decade of hospitalization.
  • The study found a stronger association between elevated admission glucose levels and increased mortality in the decade from 2000 to 2008.

Statistics:

  • 11,324 patients were included in the study.
  • The prevalence of hyperglycemia increased from 26% in the 1980s to 49% in the 2000s.
  • Adjusted 30-day mortality was 3.6-fold greater in patients with severe hyperglycemia compared with normal admission glucose levels.
  • The mortality rate was 64%, 71%, and 82% at 20 years in patients with normal, mild, and severe hyperglycemia, respectively.
  • The study found a stronger association between elevated admission glucose levels and increased mortality in the decade from 2000 to 2008, with an adjusted odds ratio of 7.7.

Sources:

  • Relation of Admission Glucose Levels, Short- and Long-Term (20-Year) Mortality After Acute Myocardial Infarction. American Journal of Cardiology, 2013;112(9):1306-1310.
  • Erasmus University Medical Center, Rotterdam, Netherlands.
  • American Journal of Cardiology, Excerpta Medica Inc-Elsevier Science Inc, 685 Route 202-206 Ste 3, Bridgewater, NJ 08807, USA.

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