CARDIOVASCULAR MEDICINE

¹ Hôpital Européen Georges Pompidou, Paris, France
² Sanofi-Aventis, Paris, France
³ CHU Dijon, Dijon, France
⁴ CHU Henri Mondor, Créteil, France
⁵ CHU Lille, Lille, France
⁶ Clinique St Gatien, Tours, France
⁷ CH Aulnay, Aulnay, France
⁸ INSERM U558, Toulouse, France

Correspondence to:
Professor Nicolas Danchin
Department of Cardiology, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France; nicolas.danchin{at}egp.ap-hop-paris.fr

Objective: To analyse the short and long term prognostic significance of admission glycaemia in a large registry of non-diabetic patients with acute myocardial infarction.

Methods: Assessment of short and long term prognostic significance of admission blood glucose in a consecutive population of 1604 non-diabetic patients admitted to intensive care units in France in November 2000 for a recent ( 48 hours) myocardial infarction.

Results: In-hospital mortality, compared with that of patients with admission glycaemia below the median value of 6.88 mmol/l (3.7%), rose gradually with each of the three upper sextiles of glycaemia: 6.5%, 12.5% and 15.2%. Conversely, one year survival decreased from 92.5% to 88%, 83% and 75% (p < 0.001). Admission glycaemia remained an independent predictor of in-hospital and one year mortality after multivariate analyses accounting for potential confounders. Increased admission glycaemia also was a predictor of poor outcome in all clinical subsets studied: patients without heart failure on admission, younger and older patients, patients with or without reperfusion therapy, and patients with or without ST segment elevation.

Conclusion: In non-diabetic patients, raised admission blood glucose is a strong and independent predictor of both in-hospital and long term mortality.

Abbreviations: AMI, acute myocardial infarction; CI, confidence interval; STEMI, ST elevation myocardial infarction

Keywords: glycaemia; acute myocardial infarction; mortality; left ventricular failure

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