Implicancias de la glicemia de ingreso en la mortalidad intrahospitalaria y alejada según el método de reperfusión en pacientes con infarto agudo del miocardio y supradesnivel del segmento ST / Admission hyperglycemia and mortality of ST segment elevation myocardial infarction
Rev. méd. Chile
;
138(9): 1109-1116, sept. 2010. ilus, tab
Article
Dans Espagnol
| LILACS
| ID: lil-572016
ABSTRACT
Background:
Hyperglycemia at admission has been associated to an adverse prognosis in patients with ST-segment elevation acute myocardial infarction (STE-MI). However, its impact over the results of reperfusion therapies in patients with STEMI is still a matter of controversy.Aim:
To determine the impact of admission hyperglycemia on hospital and long term mortality, according to the method of reper-fusion utilized in patients with STEMI. Material andMethods:
Prospective registry of 1,634 consecutive patients aged 60 ± 12 years (77 percent male), from 3 participating hospitals in the Chilean Registry of Myocardial Infarction (GEMI). We evaluated demographic, clinical and laboratory variables, reperfusion method used, hospital and long term mortality. The impact of hyperglycemia on hospital and long term mortality was evaluated by a logistic regression analysis and Cox risk, respectively, adjusted by Thrombolysis in Myocardial Infarction (TIMI) risk score.Results:
Twenty four percent of patients were diabetics and in 45 percent, the infarct was located on the anterior wall. The mean TIMI risk score was 3.2 ± 2.4. Hyperglycemia at entry was associated to a greater hospital and long term mortality, independently of the reperfusion strategy utilized. Primary angioplasty was associated to a greater benefit, compared to thrombolysis among hyperglycemic patients with an odds ratio 2.9, 95 percent confi dence intervals 1.0-8.0 and a hazard ratio of 2.9, 95 percent confi dence intervals 1.44-5.88, independently of a previous history of diabetes mellitus and TIMI risk score.Conclusions:
In patients with STEMI, admission hyperglycemia is associated with a worse prognosis which was significantly improved with primary angioplasty compared to thrombolysis, independently of the admission TIMI risk score.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Glycémie
/
Reperfusion myocardique
/
Mortalité hospitalière
/
Hyperglycémie
/
Infarctus du myocarde
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Chili
langue:
Espagnol
Texte intégral:
Rev. méd. Chile
Thème du journal:
Médicament
Année:
2010
Type:
Article
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS