Objective: To evaluate the predictive value of the admission blood glucose level for in-hospital mortality and major adverse cardiac events (MACE) rate in patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI).
Methods: The cohort study comprised 312 consecutive patients with AMI who underwent primary PCI within 24 hours after the onset of chest pain, including diabetic patients and non-diabetic patients. According to the levels of the admission glucose (11 mmol/L), these patients were divided into two groups: a high admission glucose group and a normal admission glucose group.
Results: There were no significant differences in age, hypertension, hyperlipidemia, LVEF, CK-MB and hypersensitive C reactive protein. PCI success rate was similar in both groups (P > 0.05). The in-hospital mortality and 180-day MACE rate were significantly higher in patients with high concentration of admission glucose than in patients with normal concentration (18.2% vs 3.0% P < 0.001, 25% vs 12.7%, P = 0.047). However, there was no significant difference in mortality and 180-day MACE rate between diabetic and non-diabetic patients. Binary logistic regression analysis indicated that high concentration of the admission glucose remained an independent predicator of the in-hospital mortality (OR 5.15, 95% CI 1.74 - 15.28, P = 0.003) and higher occurrence rate of 180-day MACE (OR 2.84, 95% CI 1.18 - 6.83, P = 0.019).
Conclusions: High concentration of admission glucose, but not the diagnosis of diabetes, was an important predictor for in-hospital mortality and 180-day MACE rate in patients with AMI who underwent primary PCI.