Assocation of Admission Glucose Level and Adverse Cardiac Event in Patient with Acute Myocardial Infarction

Among various risk factors of ischemic heart diseases, Diabetes mellitus is associated with high risk of coronary heart disease and risk of mortality and cardiac complications is elevated in diabetic patients admitted with acute Myocardial Infarction (MI). Also recent surveys have indicated that admission blood glucose is associated with worse prognosis. To investigate the association between admission glucose level and cardiac events (arrhythmia, acute heart failure, cardiogenic shock and death) in the patients with acute MI and determine the range of glucose level which is more prognostic for cardiac events. A cross-sectional study was done on 255 patients with acute MI. Blood samples were taken for blood glucose, cardiac troponin I (CTPI), LDL, and HbA1C in the admission.patients were stratified to three groups on the basis of admission glucose: <=140 mg/dl, 140-200mg/dl, >=200mg/dl. They were followed for adverse cardiac events during hospitalization up to five days. The results were analyzed by SPSS v18 and Chi-Square test. P<0.05 was considered significant. Totally, 255 sequential patients admitted for acute MI (179 males and 76 females) with the mean (SD) age of 66 ± 10 years old entered the study. The mean (SD) admission blood glucose level was 177.8 ± 91 mg/dl. There was a significant association between blood glucose levels and the incidence of adverse cardiac events such as death, arrhythmia, cardiogenic shock and acute heart failure (P=0.0001, P= 0.003, P= 0.0001, P= 0.0001, respectively). The relationship between Hb A1c and adverse cardiac events (death, arrhythmia, cardiogenic shock and acute heart failure) was also significant (P= 0.001, P= 0.002, P= 0.025, P= 0.0001, respectively) Our study showed that admission blood glucose levels higher than 200 mg/dl is strongly predictive of adverse cardiac events.