Blood glucose level as a risk predictor of non-diabetic patients admitted with acute myocardial infarction

ABSTRACT

Hyperglycemia is associated with increased levels of inflammatory markers in patients with acute myocardial infarction and in acutely ill patients in general. The aim of the study is to determine whether admission blood glucose level can be used as a risk predictor in acute myocardial infarction in non-diabetic patients. Follow up of all non-diabetic patients admitted to I.C.U, with a definitive diagnosis of acute myocardial infarction between December 2002 to February 2005 was carried out. A total of 90 patients were studied and followed for six months. Glycosated haemoglubin was done to exclude previously high blood sugar. The studied patients were randomized according to the outcome trying to correlate it with the level of blood sugar during admission. The mean age was 55 years [range 36-83 years], and male to female ratio was 6.51. Admission blood glucose level was significantly higher in patients who developed heart failure, reinfarction and those who died, 8.9 mmol/l versus 7.3 mmol/l, 8.3 mmol/l versus 7.1 nomol/l and 9.4 mmol/l versus 7.7 mmol/l [P=0.01, .13, .003 respectively]. Old age was also significantly associated with poor outcome, at the same time there was significant relation between the peak cardiac enzyme [creatinine phosphokinase] level and worse outcome. Admission blood glucose level after acute myocardial infarction [AMI] is an independent predictor of long term mortality and morbidity without known diabetes. Patients with unknown diabetes and high glucose level in admission with AMI have higher rate of complication, a point that may serve to identify subjects at high risk