Abstract 14823: Impact of Hyperglycemia at Admission on Thirty Days Clinical Outcomes for the Out-of-hospital Cardiac Arrest of Patients Acute Coronary Syndrome Undergoing Coronary Intervention with Hypothermia Therapy.
Background: Hyperglycemia affected the clinical result of acute myocardial infarction underwent coronary intervention. The aim of this study was to evaluate the effect of hyperglycemia at admission on the 30-days clinical outcomes of the patients (pts) with cardiac arrest due to acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with mild therapeutic hypothermia (MHT).
Methods: Data over a five-year period (2005–2009) were obtained for 452 patients treated with MHT from a multicenter registry in Japan. Of these patients, all of 193 pts were diagnosed with ACS by emergency angiography immediately after recovery of spontaneous circulation (ROSC), and were subsequently treated with MHT and PCI. These patients were divided into groups based on the blood glucose (BS) at admission; Group A: BS at admission >300mg/dl and Group B: BS at admission =<300mg/dl. Cerebral performance category (CPC) with levels 1 (Normal mental performance), 2 (moderate disability), 3 (severe disability), 4 (vegetative state), 5 (death) was used at 30days. Poor neurologic outcome was defined in CPC 3, 4 and 5.
Results: Patient demographics of Group A (n=71) were younger (mean age 58 vs. 64, p<0.0001), longer time from arrest to ROSC (42min. vs. 30 min., p=0.0018). The proportions of shockable rhythm and the time to achieve target temperature were not different. There was no significantly different in survival rate (74.1% vs. 79.1%, p=0.4775) between the two groups, however, neurologic outcome was significantly better in group B compared with group A (35.2% vs. 60.0%, p=0.0010). Logistic regression analysis revealed that the predictors of poor neurologic outcome were shockable rhythm (Odds ratio [OR]: 12.0, p<0.0001), age over 70 (OR: 7.7, p<0.0001), time from collapse to ROSC (OR 4.3, p<0.0001), and BS at admission over 300mg/dl (OR: 2.8, p=0.0060).
Conclusions: Hyperglycemia at admission did not affect the mortality; however, had an impact on neurologic outcome for the patients with ROSC after cardiac arrest due to ACS undergoing PCI with MHT.
- © 2010 by American Heart Association, Inc.