Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction in non-diabetic patients with ST-segment elevation myocardial infarction
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Recent studies have shown that acute blood glucose elevation in patients with ST-segment elevation myocardial infarction (STEMI) suggests a poor prognosis. To investigate the effect of fasting blood glucose (FBG) on the risk of heart failure (HF) and left ventricular systolic dysfunction (LVSD) in non-diabetic patients undergoing primary percutaneous coronary intervention (PCI) for acute STEMI, we retrospectively recruited consecutive non-diabetic patients who underwent primary PCI for STEMI in our hospital from February 2003 to March 2015. The patients were divided into two groups according to the FBG level. A total of 623 patients were recruited with an age of 61.3±12.9 years, of whom 514 (82.5%) were male. The HF risk (odds ratio 3.401, 95% confidence interval (CI) 2.144–5.395, P <0.001) was significantly increased in patients with elevated FBG than those with normal FBG. Elevated FBG was also independently related to LVSD (β 1.513, 95%CI 1.282–1.785, P <0.001) in a multiple logistics regression analysis. In conclusion, elevated FBG was independently associated with 30-day HF and LVSD risk in non-diabetic patients undergoing primary PCI for STEMI.
. [J]. Frontiers of Medicine, 2021, 15(1): 70-78.
Hui Wang, Yang Zhang, Zhujun Shen, Ligang Fang, Zhenyu Liu, Shuyang Zhang. Prognostic value of fasting glucose on the risk of heart failure and left ventricular systolic dysfunction in non-diabetic patients with ST-segment elevation myocardial infarction. Front. Med., 2021, 15(1): 70-78.
JA Ezekowitz, P Kaul, JA Bakal, PW Armstrong, RC Welsh, FA McAlister. Declining in-hospital mortality and increasing heart failure incidence in elderly patients with first myocardial infarction. J Am Coll Cardiol 2009; 53(1): 13–20 https://doi.org/10.1016/j.jacc.2008.08.067
pmid: 19118718
3
J Li, X Li, Q Wang, S Hu, Y Wang, FA Masoudi, JA Spertus, HM Krumholz, L Jiang; China PEACE Collaborative Group. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. Lancet 2015; 385(9966): 441–451 https://doi.org/10.1016/S0140-6736(14)60921-1
pmid: 24969506
4
JR Timmer, M Hoekstra, MW Nijsten, IC van der Horst, JP Ottervanger, RJ Slingerland, JH Dambrink, HJ Bilo, F Zijlstra, AW van’t Hof. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention. Circulation 2011; 124(6): 704–711 https://doi.org/10.1161/CIRCULATIONAHA.110.985911
pmid: 21768543
5
D Planer, B Witzenbichler, G Guagliumi, JZ Peruga, BR Brodie, K Xu, M Fahy, R Mehran, GW Stone. Impact of hyperglycemia in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: the HORIZONS-AMI trial. Int J Cardiol 2013; 167(6): 2572–2579 https://doi.org/10.1016/j.ijcard.2012.06.054
pmid: 22795245
6
J Lønborg, N Vejlstrup, H Kelbæk, L Nepper-Christensen, E Jørgensen, S Helqvist, L Holmvang, K Saunamäki, HE Bøtker, WY Kim, P Clemmensen, M Treiman, T Engstrøm. Impact of acute hyperglycemia on myocardial infarct size, area at risk, and salvage in patients with STEMI and the association with exenatide treatment: results from a randomized study. Diabetes 2014; 63(7): 2474–2485 https://doi.org/10.2337/db13-1849
pmid: 24584550
7
M Suleiman, H Hammerman, M Boulos, MR Kapeliovich, A Suleiman, Y Agmon, W Markiewicz, D Aronson. Fasting glucose is an important independent risk factor for 30-day mortality in patients with acute myocardial infarction: a prospective study. Circulation 2005; 111(6): 754–760 https://doi.org/10.1161/01.CIR.0000155235.48601.2A
pmid: 15699267
8
M Kosiborod, SS Rathore, SE Inzucchi, FA Masoudi, Y Wang, EP Havranek, HM Krumholz. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation 2005; 111(23): 3078–3086 https://doi.org/10.1161/CIRCULATIONAHA.104.517839
pmid: 15939812
9
M Ishihara, S Kojima, T Sakamoto, K Kimura, M Kosuge, Y Asada, C Tei, S Miyazaki, M Sonoda, K Tsuchihashi, M Yamagishi, M Shirai, H Hiraoka, T Honda, Y Ogata, H Ogawa; Japanese Acute Coronary Syndrome Study (JACSS) Investigators. Comparison of blood glucose values on admission for acute myocardial infarction in patients with versus without diabetes mellitus. Am J Cardiol 2009; 104(6): 769–774 https://doi.org/10.1016/j.amjcard.2009.04.055
pmid: 19733709
10
B Ibanez, S James, S Agewall, MJ Antunes, C Bucciarelli-Ducci, H Bueno, ALP Caforio, F Crea, JA Goudevenos, S Halvorsen, G Hindricks, A Kastrati, MJ Lenzen, E Prescott, M Roffi, M Valgimigli, C Varenhorst, P Vranckx, P Widimský; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39(2): 119–177 https://doi.org/10.1093/eurheartj/ehx393
pmid: 28886621
J Kowalczyk, M Mazurek, T Zielinska, R Lenarczyk, A Sedkowska, A Swiatkowski, B Sredniawa, G Mencel, P Francuz, Z Kalarus. Prognostic significance of HbA1c in patients with AMI treated invasively and newly detected glucose abnormalities. Eur J Prev Cardiol 2015; 22(6): 798–806 https://doi.org/10.1177/2047487314527850
pmid: 24618476
13
NN Gholap, RL Mehta, L Ng, MJ Davies, K Khunti, IB Squire. Is admission blood glucose concentration a more powerful predictor of mortality after myocardial infarction than diabetes diagnosis? A retrospective cohort study. BMJ Open 2012; 2(5): e001596 https://doi.org/10.1136/bmjopen-2012-001596
pmid: 23015602
14
SW Yang, YJ Zhou, YY Liu, DY Hu, YJ Shi, XM Nie, F Gao, B Hu, DA Jia, Z Fang, HY Han, JL Wang, Q Hua, HW Li; Beijing Elderly Acute Myocardial Infarction Study (BEAMIS) Group. Influence of abnormal fasting plasma glucose on left ventricular function in older patients with acute myocardial infarction. Angiology 2012; 63(4): 266–274 https://doi.org/10.1177/0003319711413893
pmid: 21733946
15
EJ Kim, MH Jeong, JH Kim, TH Ahn, KB Seung, DJ Oh, HS Kim, HC Gwon, IW Seong, KK Hwang, SC Chae, KB Kim, YJ Kim, KS Cha, SK Oh, JK Chae; KAMIR-NIH registry investigators. Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients. Int J Cardiol 2017; 236: 9–15 https://doi.org/10.1016/j.ijcard.2017.01.095
pmid: 28126258
16
J Leor, U Goldbourt, H Reicher-Reiss, E Kaplinsky, S Behar. Cardiogenic shock complicating acute myocardial infarction in patients without heart failure on admission: incidence, risk factors, and outcome. Am J Med 1993; 94(3): 265–273 https://doi.org/10.1016/0002-9343(93)90058-W
pmid: 8452150
17
GA Oswald, CC Smith, DJ Betteridge, JS Yudkin. Determinants and importance of stress hyperglycaemia in non-diabetic patients with myocardial infarction. Br Med J (Clin Res Ed) 1986; 293(6552): 917–922 https://doi.org/10.1136/bmj.293.6552.917
pmid: 3094714
18
R Marfella, C Di Filippo, M Portoghese, F Ferraraccio, MR Rizzo, M Siniscalchi, E Musacchio, M D’Amico, F Rossi, G Paolisso. Tight glycemic control reduces heart inflammation and remodeling during acute myocardial infarction in hyperglycemic patients. J Am Coll Cardiol 2009; 53(16): 1425–1436 https://doi.org/10.1016/j.jacc.2009.01.041
pmid: 19371826
19
D Tousoulis, N Papageorgiou, E Androulakis, G Siasos, G Latsios, K Tentolouris, C Stefanadis. Diabetes mellitus-associated vascular impairment: novel circulating biomarkers and therapeutic approaches. J Am Coll Cardiol 2013; 62(8): 667–676 https://doi.org/10.1016/j.jacc.2013.03.089
pmid: 23948511
20
K Yahagi, FD Kolodgie, C Lutter, H Mori, ME Romero, AV Finn, R Virmani. Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus. Arterioscler Thromb Vasc Biol 2017; 37(2): 191–204 https://doi.org/10.1161/ATVBAHA.116.306256
pmid: 27908890
21
ME Stegenga, SN van der Crabben, M Levi, AF de Vos, MW Tanck, HP Sauerwein, T van der Poll. Hyperglycemia stimulates coagulation, whereas hyperinsulinemia impairs fibrinolysis in healthy humans. Diabetes 2006; 55(6): 1807–1812 https://doi.org/10.2337/db05-1543
pmid: 16731846
22
SB Kristiansen, KB Pælestik, J Johnsen, NR Jespersen, K Pryds, MV Hjortbak, RV Jensen, HE Bøtker. Impact of hyperglycemia on myocardial ischemia-reperfusion susceptibility and ischemic preconditioning in hearts from rats with type 2 diabetes. Cardiovasc Diabetol 2019; 18(1): 66 https://doi.org/10.1186/s12933-019-0872-7
pmid: 31151453
23
JR Kersten, WG Toller, JP Tessmer, PS Pagel, DC Warltier. Hyperglycemia reduces coronary collateral blood flow through a nitric oxide-mediated mechanism. Am J Physiol Heart Circ Physiol 2001; 281(5): H2097–H2104 https://doi.org/10.1152/ajpheart.2001.281.5.H2097
pmid: 11668071
24
T Kümler, GH Gislason, L Køber, C Torp-Pedersen. Persistence of the prognostic importance of left ventricular systolic function and heart failure after myocardial infarction: 17-year follow-up of the TRACE register. Eur J Heart Fail 2010; 12(8): 805–811 https://doi.org/10.1093/eurjhf/hfq071
pmid: 20494923
25
M Fujino, M Ishihara, S Honda, S Kawakami, T Yamane, T Nagai, K Nakao, T Kanaya, L Kumasaka, Y Asaumi, T Arakawa, Y Tahara, M Nakanishi, T Noguchi, K Kusano, T Anzai, Y Goto, S Yasuda, H Ogawa. Impact of acute and chronic hyperglycemia on in-hospital outcomes of patients with acute myocardial infarction. Am J Cardiol 2014; 114(12): 1789–1793 https://doi.org/10.1016/j.amjcard.2014.09.015
pmid: 25438903
26
G Marenzi, G Lauri, E Assanelli, J Campodonico, M De Metrio, I Marana, M Grazi, F Veglia, AL Bartorelli. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004; 44(9): 1780–1785 https://doi.org/10.1016/j.jacc.2004.07.043
pmid: 15519007
27
HM Sadeghi, GW Stone, CL Grines, R Mehran, SR Dixon, AJ Lansky, M Fahy, DA Cox, E Garcia, JE Tcheng, JJ Griffin, TD Stuckey, M Turco, JD Carroll. Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. Circulation 2003; 108(22): 2769–2775 https://doi.org/10.1161/01.CIR.0000103623.63687.21
pmid: 14638545
28
JM Stolker, PA McCullough, S Rao, SE Inzucchi, JA Spertus, TM Maddox, FA Masoudi, L Xiao, M Kosiborod. Pre-procedural glucose levels and the risk for contrast-induced acute kidney injury in patients undergoing coronary angiography. J Am Coll Cardiol 2010; 55(14): 1433–1440 https://doi.org/10.1016/j.jacc.2009.09.072
pmid: 20359592
29
Y Shacham, A Gal-Oz, E Leshem-Rubinow, Y Arbel, G Keren, A Roth, A Steinvil. Admission glucose levels and the risk of acute kidney injury in nondiabetic ST segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Cardiorenal Med 2015; 5(3): 191–198 https://doi.org/10.1159/000430472
pmid: 26195971
30
K Malmberg, L Rydén, H Wedel, K Birkeland, A Bootsma, K Dickstein, S Efendic, M Fisher, A Hamsten, J Herlitz, P Hildebrandt, K MacLeod, M Laakso, C Torp-Pedersen, A Waldenström; DIGAMI 2 Investigators. Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity. Eur Heart J 2005; 26(7): 650–661 https://doi.org/10.1093/eurheartj/ehi199
pmid: 15728645
31
NW Cheung, VW Wong, M McLean. The Hyperglycemia: Intensive Insulin Infusion in Infarction (HI-5) study: a randomized controlled trial of insulin infusion therapy for myocardial infarction. Diabetes Care 2006; 29(4): 765–770 https://doi.org/10.2337/diacare.29.04.06.dc05-1894
pmid: 16567812