Changes during hospitalization may aid clinicians in rating mortality risk post-myocardial infarction
FRIDAY, Nov. 6 (HealthDay News) -- Fasting glucose changes during acute myocardial infarction hospitalizations may serve as better prognostic indicators than fasting glucose taken at baseline, according to an Israeli study in the Oct. 15 American Journal of Cardiology.
Doron Aronson, M.D., of the Rambam Medical Center in Haifa, Israel, and colleagues analyzed data from 1,467 patients without diabetes who presented with acute myocardial infarction. Patients' fasting glucose was assessed twice during hospitalization and they were followed for a median 30 months for all-cause mortality.
The researchers found that mean fasting glucose better predicted mortality than the measurement at baseline or later in the stay alone. During hospitalization, fasting glucose changes were linked to changes in risk of mortality. Patients whose fasting glucose increased to the diabetic range had a higher risk of mortality than those who remained normal (adjusted hazard ratio, 2.6). In patients whose fasting glucose stayed in the diabetic range, the hazard ratio was 6.3, and for those whose glucose fell to normal, the hazard ratio was 2.7.
"Although in-hospital improvement in fasting glucose was associated with improved outcome, long-term mortality remained higher even in patients in whom increased fasting glucose at admission returned to normal levels at discharge compared to patients with persistently normal fasting glucose levels. These results indicate that even a transient increase in fasting glucose portends increased long-term mortality," the authors conclude. "Changes in fasting glucose during hospitalization are simple and sensitive indicators of dynamic changes in risk."