Baris Gencer1, Fabio Rigamonti1,2, David Nanchen3, Roland Klingenberg4, Lorenz Räber5, Elisavet Moutzouri6,7, Reto Auer6, David Carballo1, Dik Heg7, Stephan Windecker5, Thomas Felix Lüscher4, Christian M Matter4, Nicolas Rodondi6,8, François Mach1, Marco Roffi1. 1. Cardiology Division, Geneva University Hospitals, Switzerland. 2. Department of Internal Medicine, University of Genoa, Italy. 3. Department of Ambulatory Care and Community Medicine, Lausanne University, Switzerland. 4. Department of Cardiology, University of Zurich, Switzerland. 5. Department of Cardiology, University Hospital of Bern, Switzerland. 6. Institute of Primary Health Care (BIHAM), University of Bern, Switzerland. 7. Department of Clinical Research, University of Bern, Switzerland. 8. Department of General Internal Medicine, Bern University Hospital, Switzerland.
Abstract
BACKGROUND: Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes. METHODS AND RESULTS: 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). CONCLUSION: 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.
BACKGROUND: Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes. METHODS AND RESULTS: 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). CONCLUSION: 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.
Authors: Patric Winzap; Allan Davies; Roland Klingenberg; Slayman Obeid; Marco Roffi; François Mach; Lorenz Räber; Stephan Windecker; Christian Templin; Fabian Nietlispach; David Nanchen; Baris Gencer; Olivier Muller; Christian M Matter; Arnold von Eckardstein; Thomas F Lüscher Journal: Cardiovasc Diabetol Date: 2019-10-31 Impact factor: 9.951
Authors: Hye Soo Chung; Soon Young Hwang; Jung A Kim; Eun Roh; Hye Jin Yoo; Sei Hyun Baik; Nan Hee Kim; Ji A Seo; Sin Gon Kim; Nam Hoon Kim; Kyung Mook Choi Journal: Cardiovasc Diabetol Date: 2022-01-31 Impact factor: 9.951