Prognostic values of fasting hyperglycaemia in non-diabetic patients with acute coronary syndrome: A prospective cohort study.

Details

Serval ID
serval:BIB_8053F0321FE0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prognostic values of fasting hyperglycaemia in non-diabetic patients with acute coronary syndrome: A prospective cohort study.
Journal
European heart journal. Acute cardiovascular care
Author(s)
Gencer B., Rigamonti F., Nanchen D., Klingenberg R., Räber L., Moutzouri E., Auer R., Carballo D., Heg D., Windecker S., Lüscher T.F., Matter C.M., Rodondi N., Mach F., Roffi M.
ISSN
2048-8734 (Electronic)
ISSN-L
2048-8726
Publication state
In Press
Peer-reviewed
Oui
Pages
2048872618777819
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes.
We evaluated the prevalence of hyperglycaemia (defined as fasting glycaemia ⩾10 mmol/l) among patients with no known diabetes at the time of enrolment in the prospective Special Program University Medicine-Acute Coronary Syndromes cohort, as well as its impact on all-cause death, myocardial infarction, stroke and incidence of diabetes at one year. Among 3858 acute coronary syndrome patients enrolled between December 2009-December 2014, 709 (18.4%) had known diabetes, while 112 (3.6%) of non-diabetic patients had hyperglycaemia at admission. Compared with non-hyperglycaemic patients, hyperglycaemic individuals were more likely to present with ST-elevation myocardial infarction and acute heart failure. At discharge, hyperglycaemic patients were more frequently treated with glucose-lowering agents (8.9% vs 0.66%, p<0.001). At one-year, adjudicated all-cause death was significantly higher in non-diabetic patients presenting with hyperglycaemia compared with patients with no hyperglycaemia (5.4% vs 2.2%, p=0.041) and hyperglycaemia was a significant predictor of one-year mortality (adjusted hazard ratio 2.39, 95% confidence interval 1.03-5.56). Among patients with hyperglycaemia, 9.8% had developed diabetes at one-year, while the corresponding proportion among patients without hyperglycaemia was 1.8% ( p<0.001). In multivariate analysis, hyperglycaemia at presentation predicted the onset of treated diabetes at one-year (odds ratio 4.15, 95% confidence interval 1.59-10.86; p=0.004).
Among non-diabetic patients hospitalised with acute coronary syndrome, a fasting hyperglycaemia of ⩾10 mmol/l predicted one-year mortality and was associated with a four-fold increased risk of developing diabetes at one year.
Keywords
Acute coronary syndrome, diabetes, hyperglycaemia
Pubmed
Create date
15/06/2018 17:53
Last modification date
22/10/2019 20:05
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