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

Abstract

Objective: Increased admission plasma glucose can be seen in the acute phase ofacute coronary syndromes (ACS). Hence, we performed a retrospective study toevaluate the admission plasma glucose concentration in patients with ST-segmentelevation myocardial infarction (STEMI) undergoing primary percutaneous coronaryintervention (pPCI) and who had no previous diagnosis of Diabetes Mellitus (DM).Methods: This retrospective study included 2504 consecutive confirmed STEMIpatients treated with pPCI. The patients were divided into quantiles according to theadmission glucose levels. Quantile I: 94 ± 7 mg/dL (n= 626), quantile II: 112 ± 5mg/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-hospitalall-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 relationshipremained even after adjustment for all confounders.Conclusions: Even though glucose-lowering therapy is recommended in ACS patientswith glucose levels >180 mg/dL, our results showed that high plasma glucose, evenlower than 180 mg/dL, could predict in-hospital and long-term mortality.