Post-load hyperglycemia as an important predictor of long-term adverse cardiac events after acute myocardial infarction: a scientific study

Cardiovascular Diabetology

Original Investigation

Genjirou Kimura¹  Nobuaki Kokubu²  Yu Kataoka²  Hiroshi Nonogi²  Teruo Noguchi²  Yoichiro Kasahara²  Yoichi Goto²  Shuichi Kitada³  Yoritaka Otsuka⁴ 

[1] Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan;Department of Cardiology, National Cardiovascular Center, Osaka, Japan;Department of Cardiology, National Cardiovascular Center, Osaka, Japan;Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan;Department of Cardiology, National Cardiovascular Center, Osaka, Japan;Department of Cardiology, Fukuoka Wajiro Hospital, Fukuoka, Japan;

关键词: Acute Myocardial Infarction;    Oral Glucose Tolerance Test;    Impaired Glucose Tolerance;    Normal Glucose Tolerance;    Major Adverse Cardiac Event;   

DOI  :  10.1186/1475-2840-9-75

 received in 2010-09-07, accepted in 2010-11-11,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDiabetes mellitus (DM) and impaired glucose tolerance (IGT) are risk factors for acute myocardial infarction (AMI). However, it is unknown whether hyperglycemic state is associated with increased major adverse cardiovascular events (MACE) after AMI. In this study, we evaluated the relationship between glucometabolic status and MACE in patients after AMI, and determined the critical level of 2 h post-load plasma glucose that may be used to predict MACE.MethodsAMI patients (n = 422) were divided into 4 groups as follows: normal glucose tolerance (NGT) group, IGT group, newly diagnosed DM (NDM) group, and previously known DM (PDM) group. MACE of the 4 groups were compared for 2 years from AMI onset.ResultsThe NDM group had a significantly higher event rate than the IGT and NGT groups and had a similar event rate curve to PDM group. The logistic models analyses revealed that 2 h post-load plasma glucose values of ≥160 mg/dL was the only independent predictor of long-term MACE after AMI (p = 0.028, OR: 1.85, 95% CI: 1.07-3.21). The 2-year cardiac event rate of patients with a 2 h post-load hyperglycemia of ≥160 mg/dL was significantly higher than that of patients with 2 h post-load glucose of <160 mg/dL (32.2% vs. 19.8%, p < 0.05) and was similar to that of PDM group (37.4%, p = 0.513).ConclusionsNDM increases the risk of MACE after AMI as does PDM. Particularly, post-AMI patients with a 2 h post-load hyperglycemia ≥160 mg/dL may need adjunctive therapy after AMI.

【 授权许可】

Unknown   
© Kitada et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.