Elevated Glucose on Admission Was an Independent Risk Factor For 30-Day Major Adverse Cardiovascular Events in Patients with STEMI But Not NSTEMI

Abstract

Abstract Objectives The purpose of this study was to evaluate the impact of glucose levels on admission on the risk of 30-day major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI), and to assess the difference in outcome between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) patients. Methods and Results This study was a post hoc analysis of the Acute Coronary Syndrome Quality Improvement in Kerala Study, and 13,398 participants were included in the final analysis. There was a positive linear association between glucose levels at admission and the risk of 30-day MACEs in AMI patients [adjusted OR (95%CI): 1.05 (1.03, 1.07), P < 0.001]. Participants were divided according to the glucose quintiles. Compared with participants with admission glucose between 5.4 and 6.3 mmol/L, participants with the highest quintile of glucose level (≥ 10.7 mmol/L) were associated with increased risk of 30-day MACEs in the fully adjusted logistic regression model [adjusted OR (95%CI): 1.82 (1.33, 2.50), P < 0.001]. This trend was more significant in patients with STEMI (P for interaction = 0.036). Conclusion In patients with AMI, elevated glucose on admission was associated with the increased risk of 30-day MACEs, but only in patients with STEMI.