Session: SUN 758-779-Cardiometabolic Risk & Vascular Biology
Poster Board SUN-765
Methods and results: We analyzed the prognostic significance of hypoglycemia and hyperglycemia in 28,880 AMI patients with or without type 2 diabetes mellitus (T2DM). The patients were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR) from 2005 to 2008 and Korea Working Group on Myocardial Infarction (KorMI) upto 2012 to study clinical outcome of coronary interventions. The patients were divided into 5 groups according to serum glucose levels on admission: 70 or less than; 70-139; 140-199; 200-259; 260 mg/dl or more. 30-day mortality in the lowest and highest glucose groups was higher than in other groups, with the highest mortality in the lowest group in both patients with and without T2DM after adjustments for many factors. However, HbA1c level in patients T2DM was not correlated with 30 day mortality. We also stratified T2DM patients based on HbA1c and serum glucose levels: 1st, < 6.5% and < 70 mg/dL; 2nd, Hb A1c < 6.5% and ≥ 200 mg/dL; 3rd, ≥ 8% and < 70 mg/dL; 4th, A1c ≥ 8% and ≥ 200 mg/dl. Interestingly, the 3rdgroup (with admission hypoglycemia and poor previous glucose control) showed highest 30 day mortality among the groups. Furthermore, among T2DM patients, patients with hyperglycemia on admission had lower 30 day mortality than in those with hypoglycemia regardless of HbA1c level.
Conclusion: Hypoglycemia on admission, especially in poorly controlled T2DM patients strongly predicts high 30-day mortality in AMI patients. These data suggest hypoglycemia on admission may affect clinical outcomes differently in AMI patients according to the presence and metabolic control of T2DM.
Nothing to Disclose: SAL, JMC, EJK, TDK, GK, DHL
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