The risk of diabetes development in long-term observation of patients with acute hyperglycaemia during myocardial infarction

Abstract

Background: Acute hyperglycaemia in patients with myocardial infarction (MI) is an unfavourable predictive factor. However, there are limited data regarding the relationship between acute hyperglycaemia and the incidence of new onset diabetes in long-term observation. Aim: We studied the relationship between admission glycaemia in patients with MI and the future development of diabetes. Methods: In 190 patients admitted during 2004-2007 with MI, diabetes was excluded on the basis of oral glucose tolerance test performed at the end of hospitalisation. Patients were divided into three groups according to admission glucose level: G1 < 7.8 mmol/L (< 140 mg/dL); G2: 7.8-11.0 mmol/L (140-199 mg/dL); and G3 ≥ 11.1 mmol/L (≥ 200 mg/dL). Results: The groups consisted of 80 (42.1%), 94 (49.5%), and 16 (8.4%) patients, respectively for G1, G2, and G3. The mean age was 61.3 ± 11.3 years. ST-segment elevation MI was diagnosed in 158 (83.2%) patients and non-ST-segment elevation MI in 32 (16.8%) patients. A total of 15 cases (7.9% of the study group) of newly diagnosed diabetes mellitus were registered during a mean follow-up of 48.2 ± 13.9 months. Higher incidence of new diabetes diagnosis was noticed in patients with higher glucose level on admission (5.0% vs. 7.4% vs. 25.0%, respectively; p = 0.0249). Regression analysis showed two independent risk factors of diabetes development in the observational period: admission glucose level considered as a continuous variable with odds ratio (OR) 1.2 (95% CI 1.0-1.4, p = 0.03) and occurrence of impaired fasting glucose with OR 3.6 (95% CI 1.0-12.0, p = 0.04). Conclusions: Patients with acute hyperglycaemia during MI are more likely to have diabetes in future. This group of patients requires close monitoring of glucose metabolism after MI.