E0446 Differential influence of abnormal fasting plasma glucose on mortality and left ventricular function in older patients with acute myocardial infarction results from the BEAMIS study. (17th November 2010)

• Record Type: Journal Article
• Authors: Shiwei, Yang; Yujie, Zhou; Dayi, Hu; Xiaomin, Nie; Dean, Jia; Bin, Hu; Zhe, Fang; Fei, Gao; Hongya, Han; Zhenxian, Yan; Xiaoli, Liu
• Is Part Of: Heart. Volume 96(2010)Supplement 3
• Page Start: A139
• Page End: A139
• Publication Date: 2010-11-17
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2010.208967.446
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: The aim of this study was to assess whether the admission FPG levels were associated with all-cause mortality and left ventricular (LV) function in older patients with acute myocardial (AMI) by analysing data from the Beijing Elderly Acute Myocardial Infarction Study (BEAMIS). Methods: From April 2004 to October 2006, 1854 older (age ≥65 years) AMI patients were consecutively enrolled in BEAMIS Patients were categorised into 4 groups: hypoglycemia group (N=443, 23.9%), FPG≤5 mmol/l; euglycemia group (N=812, 43.8%), 5.1 mmol/L≤FPG≤7 mmol/l (5–7 mmol/l); mild hyperglycemia group (N=308, 16.6%), 7.1 mmol/L≤FPG≤9 mmol/l (7–9 mmol/l); and severe hyperglycemia group (N=291, 15.7%), FPG≥9.1 mmol/l. The primary outcomes were in-hospital and 3-year mortality and LV function during admission. Results: There was a near-linear relationship between FPG levels and Killip class, with Killip classes I/II and III/IV being more frequent among patients with hypoglycemia and hyperglycemia, respectively (p=0.011). However, no significant correlation was found between admission FPG levels and LVEF, LV end-diastolic or end-systolic diameter (p=0.837, 0.073, 0.165, respectively). Both admission FPG levels (p=0.002) and Killip classes (p<0.001) were all independent significant predictors for in-hospital/3-year mortality. Compared with the euglycemia group, both the hypo- and hyperglycemia groups were associated with higher in-hospital and 3-year all-cause mortality. Patients in the FPG 5–7 mmol/l group had the best outcome. In-hospital mortality of patients with hypoglycemia and Killip class IV was the highest in the overall cohort, followed by that of patients with severe hyperglycemia and Killip class IV (60% vs 50.0%, p=0.015). In contrast, 3-year mortality of patients with severe hyperglycemia and Killip class IV was highest followed by that of patients with hypoglycemia and Killip class IV (70% vs 60.0%, p=0.001). Conclusions: In older patients with AMI, abnormal FPG values had differential influences on LV function and mortality. Not only increased but also decreased admission FPG levels could predict in-hospital and 3-year mortality. There was a U-shaped relationship between admission FPG levels and short- or long-term mortality, and a near-linear relationship between increased admission glucose levels and higher Killip classification.