Abstract 3483: Is Admission Hyperglycemia in Non-Diabetic Patients with Acute Myocardial Infarction a Surrogate for Previously Undiagnosed Abnormal Glucose Tolerance?
Background: Hyperglycemia is a common feature during early after acute myocardial infarction (AMI) even in patients who had no previous diagnosis of diabetes and is associated with adverse outcome.
Purpose: This study was undertaken to investigate whether admission hyperglycemia in non-diabetic patients with AMI is a surrogate for previously undiagnosed abnormal glucose tolerance.
Methods: 200 non-diabetic patients with AMI were divided into 3 groups: 81 patients with admission glucose <7.8 mmol/L (group 1), 83 patients with admission glucose ≥7.8 mmol/L and <11.1 mmol/L (group 2), and 36 patients with admission glucose ≥11.1 mmol/L (group 3). Abnormal glucose tolerance, diabetes or impaired glucose tolerance (IGT), was diagnosed by oral glucose tolerance test (OGTT).
Results: OGTT identified diabetes in 53 patients (27%) and IGT in 78 patients (39%). The prevalence of abnormal glucose tolerance was similar among the 3 groups: 67% in group 1, 63% in group 2 and 69% in group 3 (p=0.74; Figure⇓). The relation of fasting glucose (r2=0.50, p<0.001) and HbA1c (r2=0.34, p<0.001) to 2-h postload glucose was significantbut not admission glucose (r2=0.02, p=0.08). Multivariable analysis showed that fasting glucose and HbA1c were independent predictors of abnormal glucose tolerance but admission glucose was not.
Conclusions: Admission hyperglycemia in non-diabetic patients with AMI does not represent previously undiagnosed abnormal glucose tolerance.