The Clinical Study Of Stress-hyperglycaemia In Nondiabetic Patients With Acute Myocardial Infarction

Objectives:To evaluate the related risk factors and impact of stress-hyperglycemia on patients with ST segment elevation acute myocardial infarction(STEMI) during primary percutaneous coronary intervention era.Methods:From August 2005 to Apirl 2009, a total of 329 non-diabetic patients were admitted to FuWai-Hospital within 12 hours after the onset of STEMI. Plasma glucose was measured on the first morning after admission.Stress-hyperglycemia was defined as fasting glucose≥7.0mmol/L. Predictors of stress-hyperglycemia were analyzed by logistic regression model. The risk of death during hospitalization was analyzed by multivariate Cox proportional hazard regression model.Results:Stress-hyperglycemia occurred in 121 out of 329 patients (36.8%). Older age [(64±12)years vs (58±12)years, P<0.001], women[(33.1% vs 13.9%, P<0.001)], Killip class≥Ⅱ[(52.9% vs 15.9%, P<0.001)], blood glucose level[(9.1±3.3)mmol/L vs (5.4±0.4)mmol/L, P<0.001], and mortality of patients with stress-hyperglycemia were significantly higher than that of patients without stress-hyperglycemia (16.5% vs 3.8%, P <0.001). Logistic regression analysis showed that patients with older age[odds ration (OR) 1.024,95% confidence interval(CI) 1.001 to 1.047, P=0.043], women[OR 3.013, 95% CI 1.617 to 5.616, P=0.001], killip class≥Ⅱ[OR 2.161,95%CI 1.532 to 3.048, P< 0.001] were independent predictors of stress-hyperglycemia after adjustment for other risk factors. Multivariate Cox proportional hazard regression model showed that stress-hyperglycemia was independent predictors of in-hospital' mortality [OR 2.459, 95%CI 1.022 to 5.921, P=0.045].Conclusions:Older age, women, killip class≥Ⅱwere related risk factors of stress-hyperglycemia in patients after STEMI. Stress-hyperglycemia after STEMI was an independent predictor and risk factor of short term prognosis.