Prognostic importance of hyperglycaemia induced by stress after acute myocardial infarction

Abstract

Our study showed that hyperglycaemia is common after acute myocardial infarction whereas high haemoglobin A1 concentrations are less common. Accordingly, routine measurement of haemoglobin A1 concentrations in patients thought to have hyperglycaemia induced by stress is unlikely to be helpful despite a previous suggestion that it is of value for early interpretation of hyperglycaemia after acute myocardial infarction. We also showed that hyperglycaemia induced by stress is associated with poor prognosis in patients who have had acute myocardial infarction. Follow up of such patients susggested that hyperglycaemia induced by stress is a temporary phenomenon in patients with otherwise normal carbohydrate tolerance, contrary to previous findings. We conclude that hyperglycaemia induced by stress should be considered to be a crude prognostic marker in acute myocardial infarction indicating poor prognosis and high mortality.