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  3. Prognostic values of fasting hyperglycaemia in non-diabetic patients with acute coronary syndrome: A prospective cohort study.
 

Prognostic values of fasting hyperglycaemia in non-diabetic patients with acute coronary syndrome: A prospective cohort study.

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BORIS DOI
10.7892/boris.117163
Date of Publication
September 2020
Publication Type
Article
Division/Institute

Clinical Trials Unit ...

Universitätsklinik fü...

Berner Institut für H...

Author
Gencer, Baris
Rigamonti, Fabio
Nanchen, David
Klingenberg, Roland
Räber, Lorenz
Universitätsklinik für Kardiologie
Moutzouri Beifuss, Elisavet
Berner Institut für Hausarztmedizin (BIHAM)
Auer, Reto
Berner Institut für Hausarztmedizin (BIHAM)
Carballo, David
Heg, Dierik Hansorcid-logo
Clinical Trials Unit Bern (CTU)
Windecker, Stephan
Universitätsklinik für Kardiologie
Lüscher, Thomas Felix
Matter, Christian M
Rodondi, Nicolas
Berner Institut für Hausarztmedizin (BIHAM)
Universitätsklinik für Allgemeine Innere Medizin, Kompetenzbereich für Allgemeine Innere Medizin
Mach, François
Roffi, Marco
Subject(s)

600 - Technology::610...

300 - Social sciences...

Series
European Heart Journal: Acute Cardiovascular Care
ISSN or ISBN (if monograph)
2048-8734
Publisher
Sage
Language
English
Publisher DOI
10.1177/2048872618777819
PubMed ID
29862825
Uncontrolled Keywords

Acute coronary syndro...

Description
BACKGROUND

Controversy remains regarding the prevalence of hyperglycaemia in non-diabetic patients hospitalised with acute coronary syndrome and its prognostic value for long-term outcomes.

METHODS AND RESULTS

We evaluated the prevalence of hyperglycaemia (defined as fasting glycaemia ⩾10 mmol/l) among patients with no known diabetes at the time of enrolment in the prospective Special Program University Medicine-Acute Coronary Syndromes cohort, as well as its impact on all-cause death, myocardial infarction, stroke and incidence of diabetes at one year. Among 3858 acute coronary syndrome patients enrolled between December 2009-December 2014, 709 (18.4%) had known diabetes, while 112 (3.6%) of non-diabetic patients had hyperglycaemia at admission. Compared with non-hyperglycaemic patients, hyperglycaemic individuals were more likely to present with ST-elevation myocardial infarction and acute heart failure. At discharge, hyperglycaemic patients were more frequently treated with glucose-lowering agents (8.9% vs 0.66%, p<0.001). At one-year, adjudicated all-cause death was significantly higher in non-diabetic patients presenting with hyperglycaemia compared with patients with no hyperglycaemia (5.4% vs 2.2%, p=0.041) and hyperglycaemia was a significant predictor of one-year mortality (adjusted hazard ratio 2.39, 95% confidence interval 1.03-5.56). Among patients with hyperglycaemia, 9.8% had developed diabetes at one-year, while the corresponding proportion among patients without hyperglycaemia was 1.8% ( p<0.001). In multivariate analysis, hyperglycaemia at presentation predicted the onset of treated diabetes at one-year (odds ratio 4.15, 95% confidence interval 1.59-10.86; p=0.004).

CONCLUSION

Among non-diabetic patients hospitalised with acute coronary syndrome, a fasting hyperglycaemia of ⩾10 mmol/l predicted one-year mortality and was associated with a four-fold increased risk of developing diabetes at one year.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/162405
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FileFile TypeFormatSizeLicensePublisher/Copright statementContent
Gencer EurHeartJAcuteCardiovascCare 2018.pdftextAdobe PDF361.85 KBpublisherpublished restricted
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