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Major impact of admission glycaemia on 30 day and one year mortality in non-diabetic patients admitted for myocardial infarction: results from the nationwide French USIC 2000 study
  1. Z Kadri1,
  2. N Danchin2,
  3. L Vaur3,
  4. Y Cottin5,
  5. P Guéret7,
  6. M Zeller6,
  7. J-M Lablanche8,
  8. D Blanchard6,
  9. G Hanania7,
  10. N Genès4,
  11. J-P Cambou8,
  12. on behalf of the USIC 2000 Investigators
  1. 1Hôpital Européen Georges Pompidou, Paris, France
  2. 2Sanofi-Aventis, Paris, France
  3. 3CHU Dijon, Dijon, France
  4. 4CHU Henri Mondor, Créteil, France
  5. 5CHU Lille, Lille, France
  6. 6Clinique St Gatien, Tours, France
  7. 7CH Aulnay, Aulnay, France
  8. 8INSERM U558, Toulouse, France
  1. 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

Abstract

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.

  • AMI, acute myocardial infarction
  • CI, confidence interval
  • STEMI, ST elevation myocardial infarction
  • glycaemia
  • acute myocardial infarction
  • mortality
  • left ventricular failure

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Footnotes

  • The USIC 2000 was made possible through an unrestricted grant from Laboratoire Sanofi-Aventis

  • Several of the authors received honoraria from Sanofi-Aventis for participating in the steering committee of the USIC registry

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