The Impact of Plasma Glucose Levels on In-Hospital and Long-Term Mortality in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction Patients

Abstract

Objective: Increased admission plasma glucose can be seen in the acute phase of acute coronary syndromes (ACS). Hence, we performed a retrospective study to evaluate the admission plasma glucose concentration in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) and who had no previous diagnosis of Diabetes Mellitus (DM). Methods: This retrospective study included 2504 consecutive confirmed STEMI patients treated with pPCI. The patients were divided into quantiles according to the admission glucose levels. Quantile I: 94 +/- 7 mg/dL (n = 626), quantile II: 112 +/- 5 mg/dL (n = 626), quantile III: 131 +/- 6 mg/dL (n = 626), quantile IV: 184 +/- 46 mg/dL (n = 626). Results: Patients with higher plasma glucose (Q4) had 6.6 times higher in-hospital all-cause mortality rates (95% CI: 3.95-9.30) and 3.12 times higher (95% CI: 2.2-4.4) long-term all-cause mortality rates than patients with lower plasma glucose (Q1-Q3), who had lower rates and were used as the reference. This significant relationship remained even after adjustment for all confounders. Conclusions: Even though glucose-lowering therapy is recommended in ACS patients with glucose levels >180 mg/dL, our results showed that high plasma glucose, even lower than 180 mg/dL, could predict in-hospital and long-term mortality.