Abstract
Aims: The study evaluated the associations between glycometabolic parameters at admission and during hospitatization and 2 year all-cause mortality risk in an unselected cohort of consecutive patients with diabetes admitted for unstable angina or non-Q-wave myocardial infarction to a university hospital during 1988-98. Methods and results: A total of 713 consecutive patients with diabetes were included. During 2 years of follow-up, 242 (34%) patients died. All analyses were retrospective using prospectively collected clinical data. The primary study endpoint was 2 year all-cause mortality collected from the Swedish cause-specific mortality register. In unadjusted analyses, high admission blood glucose (highest vs. lowest quartile: hazard ratio (HR) 2.66; 95% confidence interval (CI) 1.83, 3.86) and hypoglycaemia recorded during hospitalization (hypoglycaemia vs. normal: HR 1.77; 95% CI 1.09, 2.86) were both significantly associated with increased 2 year all-cause mortality risk. These associations remained significant after multivariable adjustment. Conclusion: In the setting of acute coronary syndromes (ACS) among patients with diabetes, hyperglycaemia on arrival and hypoglycaemia during hospitalization are both independently associated with worse adjusted all-cause 2 year mortality risk. These observations suggest that the avoidance of both hyper- and hypoglycaemia during ACS events may be of similar importance, and glucose modulation remains an important objective to address in future randomized trials.
Original language | English (US) |
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Pages (from-to) | 1255-1261 |
Number of pages | 7 |
Journal | European heart journal |
Volume | 26 |
Issue number | 13 |
DOIs | |
State | Published - Jul 2005 |
Keywords
- Diabetes mellitus
- Hyperglycaemia
- Hypoglycaemia
- Non-Q-wave myocardial infarction
- Prognosis
- Unstable angina pectoris
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine