THE INFLUENCE OF GLYCEMIA ON SHORT-TERM PROGNOSIS IN MYOCARDIAL INFARCTION WITHOUT ANAMNESIS OF 2ND TYPE DIABETES
https://doi.org/10.15829/1728-8800-2014-2-29-34
Abstract
Aim. To estimate the impact of glycemia recorded during myocardial infarction (MI) in-patient care on short-term prognosis of patients without 2nd type diabetes mellitus (2DM).
Material and methods. Totally 296 patients were prospectively investigated. According to glucose levels patients were divided into three groups: 1st with ≤4,0 mM/l (7,4%); 2nd with 4,01–7,79 mM/l (69,9%); 3rd with ≥7,8 mM/l (22,6%). The rate of glucose metabolism disorders and complications during in-hospital care were studied.
Results. In 2/3 of patients with glycemia ≥7,8 mM/l at hospitalization, later the changes of glucose metabolism were found by glucosetolerance test: prediabetes (36,9%), 2DM (32,3%). In the patients of 3rd group significantly higher was the rate of 3-vessel disease (41,8%) anf MI complications: congestive left-ventricular failure — 52,2% vs 27,3% in the 1st group and 34,1% in the second (p=0,017), cardiogenic shock — 26,9% vs 4,5% and 6,8% (p<0,001), conduction disorders — 27,3% vs 9,1% and 11,7% (p=0,006), in-hospital mortality — 13,8% vs 4,5% and 4,4% (p=0,025). The risk of death in subjects with glycemia ≥7,8 mM/l was 3,48 (95% CI: 1,41–8,60) times higher than in normoglycemic (p=0,007). The glycemia was independently linked with complications of MI during in-hospital period: OR = 1,128; 95% CI: 1,005–1,266 (p=0,042), — as also with the age, severity of myocardial damage and systolic pressure at admittance.
Conclusion. There was higher prevalence of MI complications and 3 times higher risk of death in patients without 2DM, but having ≥7,8 mM/l glucose (22,6% of patients) at admittance. The glycemia parameter was an independent predictor for unfavorable prognosis of MI without previous 2DM diagnosis and should be used as part of secondary prevention care.
About the Authors
K. K. Kholmatova
The Northern State Medical University
First City Hospital n. a. Volosevitch
Russian Federation
Russian Federation
I. V. Dvoryashina
The Northern State Medical University
Russian Federation
Russian Federation
T. V. Supryadkina
First City Hospital n. a. Volosevitch
Russian Federation
Russian Federation
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Review
For citations:
Kholmatova K.K., Dvoryashina I.V., Supryadkina T.V. THE INFLUENCE OF GLYCEMIA ON SHORT-TERM PROGNOSIS IN MYOCARDIAL INFARCTION WITHOUT ANAMNESIS OF 2ND TYPE DIABETES. Cardiovascular Therapy and Prevention. 2014;13(2):29-34. (In Russ.) https://doi.org/10.15829/1728-8800-2014-2-29-34
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