Initial Serum Glucose Level as a Prognostic Factor in the First Acute Myocardial Infarction

Chin Wang Hsu, Hsiu Hsi Chen, Wayne H.H. Sheu, Shi Jye Chu, Ying Sheng Shen, Chin Pyng Wu, Kuo Liong Chien

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Study objective: We assess the prognostic role of initial glucose levels in patients with a first acute myocardial infarction in the emergency department (ED). Methods: We conducted a 3-year retrospective cohort study. Patients with a first acute myocardial infarction were recruited from the ED of a tertiary hospital from January 1, 2001, to December 31, 2003. Initial glucose levels in the ED were stratified into 3 levels (normal <140 mg/dL; intermediate 140 to 200 mg/dL; and high ≥200 mg/dL). Logistic and Cox regression models were applied to estimate the 1-month short-term and 1-year long-term adverse prognoses, respectively. Results: A total of 198 eligible subjects (159 men and 39 women; mean age 63.1±14.2 years) were recruited. The estimated survival curves among the 3 initial glucose levels were significantly different (P=.0002). After adjustment for sex, age, diabetic status, reperfusion therapy, and infarct subtype, the adjusted odds ratio for short-term prognosis progressed with higher levels when compared with the normal level (intermediate level: odds ratio 3.87; 95% confidence interval [CI] 1.71 to 8.78; high level: odds ratio 5.16; 95% CI 1.97 to 13.51). High initial glucose level was an important risk factor for long-term adverse prognosis (hazard ratio 3.08; 95% CI 1.59 to 5.98). Conclusion: A high initial glucose level in the ED is an important and independent predictor of short- and long-term adverse prognoses in patients with first acute myocardial infarction.

Original languageEnglish
Pages (from-to)618-626
Number of pages9
JournalAnnals of Emergency Medicine
Volume49
Issue number5
DOIs
Publication statusPublished - May 2007
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'Initial Serum Glucose Level as a Prognostic Factor in the First Acute Myocardial Infarction'. Together they form a unique fingerprint.

Cite this