The association between hyperglycaemia and elevated troponin levels on mortality in acute coronary syndromes

Abstract

Diabetes is associated with increased cardiovascular morbidity and mortality. We studied the relationship between hyperglycaemia, troponin I concentrations and one-year mortality in 498 subjects admitted to hospital with an acute coronary syndrome. The proportion of deaths was higher in those with hyperglycaemia (random glucose > 11. 1 mmol/L) compared to those without (27% and 12%, respectively, Chi-squared test = 9. 84, p=0. 002). There was a difference in troponin I concentration on admission between those patients who were alive and dead (median and interquartile range 0. 14 [0 to 3. 90] and 2. 98 [0. 23 to 18. 53] respectively, p<0. 001) and the risk of death was elevated in those with a myocardial infarction compared to those without (relative risk = 1. 85, 95% confidence intervals 1. 55 to 2. 21). Despite adherence to guidelines for the management of acute coronary syndromes, the presence of hyperglycaemia confers a significant long-term mortality disadvantage.