Association between hyper- and hypoglycaemia and 2 year all-cause mortality risk in diabetic patients with acute coronary events

Ann Marie Svensson, Darren K. McGuire, Putte Abrahamsson, Mikael Dellborg

Research output: Contribution to journalArticlepeer-review

254 Scopus citations

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 languageEnglish (US)
Pages (from-to)1255-1261
Number of pages7
JournalEuropean heart journal
Volume26
Issue number13
DOIs
StatePublished - Jul 2005

Keywords

  • Diabetes mellitus
  • Hyperglycaemia
  • Hypoglycaemia
  • Non-Q-wave myocardial infarction
  • Prognosis
  • Unstable angina pectoris

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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