Sang Ah Lee1, Suk Ju Cho2, Myung Ho Jeong3, Young Jo Kim4, Chong Jin Kim5, Myeong Chan Cho6, Hyo-Soo Kim7, Youngkeun Ahn8, Gwanpyo Koh1, Jeong Mi Lee9, Seok Kyu Oh10, Kyeong Ho Yun10, Ha Young Kim10, Chung Gu Cho10, Dae Ho Lee11. 1. Department of Internal Medicine, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Republic of Korea. 2. Department of Anesthesiology, Jeju National University Hospital, Jeju National School of Medicine, Jeju, Republic of Korea. 3. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea drhormone@naver.com myungho@chollian.net. 4. Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea. 5. Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea. 6. Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. 7. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 8. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea. 9. Department of Public Health, Wonkwang University, Iksan, Republic of Korea. 10. Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea. 11. Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea drhormone@naver.com myungho@chollian.net.
Abstract
OBJECTIVE: We aimed to evaluate the association between hypoglycemia at admission and 30-day mortality in patients with acute myocardial infarction (AMI) and to determine whether these associations differed according to diabetes-control status in AMI patients with diabetes. RESEARCH DESIGN AND METHODS: We analyzed the prognostic significance of hypoglycemia and hyperglycemia in 34,943 AMI patients with or without type 2 diabetes from two AMI registries: the Korea Acute Myocardial Infarction Registry (KAMIR) and the Korea Working Group on Myocardial Infarction (KorMI). RESULTS: The patients were divided into five groups according to serum-glucose levels at admission: <3.9 mmol/L (<70 mg/dL); 3.9-7.72 mmol/L (70-139 mg/dL); 7.78-11.06 mmol/L (140-199 mg/dL); 11.11-14.39 mmol/L (200-259 mg/dL); and ≥14.44 mmol/L (≥260 mg/dL). The 30-day mortality rates in the lowest and highest glucose groups were higher than those in other groups; the lowest glucose group had the highest mortality for patients with type 2 diabetes, after adjusting for multiple factors. We also extracted and compared four subgroups from the patients with type 2 diabetes, based on hemoglobin A1c and serum-glucose levels at admission: group A, <6.5% (48 mmol/mol) and <3.9 mmol/L; group B, <6.5% (48 mmol/mol) and ≥11.11 mmol/L; group C, ≥8% (64 mmol/mol) and <3.9 mmol/L; and group D, ≥8% (64 mmol/mol) and ≥11.11 mmol/L. Group C had the highest 30-day mortality rate among the groups. CONCLUSIONS: These data suggest that hypoglycemia at admission affects clinical outcomes differently in AMI patients with type 2 diabetes depending on the diabetes-control status.
OBJECTIVE: We aimed to evaluate the association between hypoglycemia at admission and 30-day mortality in patients with acute myocardial infarction (AMI) and to determine whether these associations differed according to diabetes-control status in AMI patients with diabetes. RESEARCH DESIGN AND METHODS: We analyzed the prognostic significance of hypoglycemia and hyperglycemia in 34,943 AMI patients with or without type 2 diabetes from two AMI registries: the Korea Acute Myocardial Infarction Registry (KAMIR) and the Korea Working Group on Myocardial Infarction (KorMI). RESULTS: The patients were divided into five groups according to serum-glucose levels at admission: <3.9 mmol/L (<70 mg/dL); 3.9-7.72 mmol/L (70-139 mg/dL); 7.78-11.06 mmol/L (140-199 mg/dL); 11.11-14.39 mmol/L (200-259 mg/dL); and ≥14.44 mmol/L (≥260 mg/dL). The 30-day mortality rates in the lowest and highest glucose groups were higher than those in other groups; the lowest glucose group had the highest mortality for patients with type 2 diabetes, after adjusting for multiple factors. We also extracted and compared four subgroups from the patients with type 2 diabetes, based on hemoglobin A1c and serum-glucose levels at admission: group A, <6.5% (48 mmol/mol) and <3.9 mmol/L; group B, <6.5% (48 mmol/mol) and ≥11.11 mmol/L; group C, ≥8% (64 mmol/mol) and <3.9 mmol/L; and group D, ≥8% (64 mmol/mol) and ≥11.11 mmol/L. Group C had the highest 30-day mortality rate among the groups. CONCLUSIONS: These data suggest that hypoglycemia at admission affects clinical outcomes differently in AMI patients with type 2 diabetes depending on the diabetes-control status.
Authors: Hyun Kuk Kim; Myung Ho Jeong; Seung Hun Lee; Doo Sun Sim; Young Joon Hong; Youngkeun Ahn; Chong Jin Kim; Myeong Chan Cho; Young Jo Kim Journal: Korean J Intern Med Date: 2014-10-31 Impact factor: 2.884