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Diabetes Metab Syndr ; 7(1): 42-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23517796

RESUMO

BACKGROUND: Whether persistent hyperglycemia (PG) during hospitalisation has a greater impact on adverse outcomes in acute myocardial infarction (AMI) than a single random glucose measurement is not well defined. AIMS: To find out the association of admission glycemia (AG) VS PG on outcomes in patients of ACS. STUDY DESIGN AND METHODS: Prospective, cohort, hospital-based. We evaluated 200 patients of ACS for admission and in-hospital glycemia and their impacts on outcomes. AG was defined as a plasma glucose >198 mg/dl and PG as a random glucose >140 mg/dl at any point during hospitalisation. Demographic and biochemistry including risk factors recorded. A multiple regression was done to evaluate association of various parameters with worse prognosis. RESULTS: Of the 200 patients evaluated, 35 (17.5%) presented with AG. 31 (15.5%) had PG. Males were predominant and 47 (23%) previously known diabetic patients. 62 (31%) had unstable angina, 52 (26%) NSTEMI and 86 (43%) STEMI, between PG and LEF, higher troponin levels and in-hospital mortality and between LEF and age (p<0.001), serum creatinine (p 0.023) and mean in-hospital glucose (p 0.005). F-indices were compared with AG for their ability to discriminate hospitalization survivors from non-survivors. All average glucose metrics performed better than AG. The ability of these models improved as the time window increased (F-indices for admission, mean 24h, 48 h and 72 h were 2.51, 12.05, 8.3 and 5.72, respectively). CONCLUSION: The present study demonstrates that PG is a better discriminator of prognosis than AG in patients of ACS.


Assuntos
Síndrome Coronariana Aguda/sangue , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Hospitalização , Hiperglicemia/sangue , Síndrome Coronariana Aguda/mortalidade , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/mortalidade , Feminino , Humanos , Hiperglicemia/mortalidade , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Avaliação de Resultados em Cuidados de Saúde , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco
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