Background: High admission blood glucose levels (BGL) after acute myocardial (AMI) are common and associated with an increased risk of death in subjects with and without known diabetes mellitus (DM). Recent data indicate a high prevalence of abnormal glucose metabolism in patients with unknown diabetes at the onset of AMI.
Aim: To estimate the predictive value of admission BGL after AMI for middle term prognosis in patients with and without previously diagnosed DM.
Methods and study group: The prognosis of all 870 consecutive patients (605 without and 265 with known diabetes) admitted to our coronary care unit in years 2003 and 2004 with diasnosis of AMI were follow-up during 6 months.
Results: During this period, 78 nondiabetic patients (12.9%) and 53 diabetic patients (20.0%) died (P=0.007). Of the 605 previously nondiabetic subjects, 66 (10.9%) had admission BGL of 11.1 mmol/l or more. Mortality in these patients was comparable to that in diabetics (30.3% vs.20.0%).
Conclusions: The admission BGL after AMI is an independent predictor of middle term mortality in patients with and without known DM. Subjects without DM and admission BGL of 11.1 mmol/l or more after AMI had mortality rates similar to them with established DM. Admission BGL could help to identify patients at high middle term mortality risk. It could be particularly valuable in nondiabetics