Admission hyperglycemia and adverse outcomes in diabetic and non-diabetic patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention

Abstract

Background: The association between admission hyperglycemia and adverse outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI) has not been well studied, and the optimal plasma glucose cut-off values for prognosis for NSTEMI patients with and without diabetes have not been determined. Methods: According to glucose level and diabetes status, consecutive NSTEMI patients undergoing PCI (n=890) were divided into four groups: without diabetes mellitus (DM) and admission plasma glucose (APG) <144 or ≥144mg/dL; or with DM and APG <180 or ≥180mg/dL. All patients were followed up at 30days and 3years after discharge, and the outcomes were assessed. Results: Admission hyperglycemia was found in 44 and 28% of the DM and non-DM patients, respectively. Multivariable analyses showed that the APG level was an independent predictor of 30-day and 3-year MACEs. Receiver operating characteristic curve analysis revealed that the appropriate cut-off values were 178 and 145mg/dL for patients with and without DM, respectively, or 157mg/dL for all patients. Conclusions: Admission hyperglycemia may be used to predict 30-day and 3-year MACEs in patients with NSTEMI undergoing PCI, irrespective of diabetes status. However, the optimal admission glucose cut-off values for predicting prognosis differ for patients with or without DM.