Abstract 15222: Admission Glucose Level is a Risk Factor for 30-Day Mortality in Non-Diabetic Patients with Acute Myocardial Infarction but Glycosylated Hemoglobin Level is Not

Abstract

Background - Although acute hyperglycemia is associated with adverse outcome in non-diabetic patients with acute myocardial infarction (AMI), it is unclear whether this association is due to hyperglycemia as an acute stress response or long-term poor glycemic control. We evaluated whether acute (admission glucose) or chronic hyperglycemia (hemoglobin A1c [HbA1c]) is associated with in-hospital mortality in non-diabetic patients with AMI treated with percutaneous coronary intervention (PCI).

Methods and Results - Consecutive 502 patients without history of diabetes mellitus presenting AMI were included. Both glucose and HbA1c were measured on admission. All patients were treated with PCI. Primary endpoint was 30-day mortality. Patients were divided into 4 groups according to the quartiles of glucose (median = 124.0 mg/dl, IQR 103.8 - 152.0) and HbA1c (median = 5.8%, IQR 5.6 - 6.2). Male was 75.3% and age was 65.1 ± 13.0 years. ST segment elevation myocardial infarction (STEMI) was 38.6% and non-STEMI was 61.4%. 30-day mortality was 1.6%, 3.4%, 3.1%, 13.7% according to the quartiles of glucose (p<0.001) but 7.2%, 2.6%, 3.8%, 4.0% according to the quartiles of HbA1c (p=0.501). On multivariate analysis, admission glucose was an independent risk factor for 30-day mortality.

Conclusion - In non-diabetic patients with AMI, admission glucose level was associated with 30-day mortality but HbA1c was not. This result demonstrated that acute glycometabolic derangement rather than chronic hyperglycemia is associated with short-term mortality in these patients.