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首页> 外文期刊>The American Journal of Cardiology >Predictive value of plasma glucose level on admission for short and long term mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
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Predictive value of plasma glucose level on admission for short and long term mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

机译：原发性经皮冠状动脉介入治疗ST段抬高型心肌梗死患者血浆葡萄糖水平对短期和长期死亡率的预测价值

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摘要

Published reports describe a strong association between plasma glucose levels on admission and mortality in patients who undergo primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. The aim of this study was to assess the predictive value of admission glucose levels for early and late mortality. From 2005 to 2007, 1,646 patients underwent primary percutaneous coronary intervention for ST-segment elevation myocardial infarction and were stratified according to admission plasma glucose level in category 1 (<7.8 mmol/L; n = 747), category 2 (7.8 to 11.0 mmol/L; n = 620), or category 3 (>11 mmol/L; n = 279). Event rates were estimated using the Kaplan-Meier method. A landmark survival analysis to 3-year follow-up was performed, with a landmark set at 30 days. Time-extended Cox regression was used to assess the predictive value of admission glucose levels. Furthermore, a stratified analysis was performed for known diabetes mellitus status at admission. Thirty-day mortality was 2.4% in category 1, 6% in category 2, and 22% in category 3 (p <0.01). Three-year mortality in 30-day survivors was 5.9% in category 1, 8.2% in category 2, and 7.1% in category 3 (p = 0.27). Glucose level on admission was a strong predictor of 30-day mortality: for every 1 mmol/L increase, the hazard increased by 14% (hazard ratio 1.14, 95% confidence interval 1.09 to 1.19, p <0.01) in patients without diabetes, by 12% (hazard ratio 1.12, 95% confidence interval 1.05 to 1.19, p <0.01) in those with diabetes, and by 13% (hazard ratio 1.13, 95% confidence interval 1.09 to 1.17, p <0.01) in the total cohort. After 30 days, glucose level at admission lost its predictive value. In conclusion, in patients with and those without diabetes, glucose level at admission is an independent predictor of early but not late mortality.
机译：已发表的报告描述了接受原发性经皮冠状动脉介入治疗ST段抬高型心肌梗死的患者入院时血糖水平与死亡率之间的密切关系。这项研究的目的是评估入院血糖水平对早期和晚期死亡率的预测价值。从2005年到2007年，对1646例因ST段抬高型心肌梗死行经皮冠状动脉介入治疗的患者，根据其入院血浆葡萄糖水平分为1类（<7.8 mmol / L; n = 747），2类（7.8-11.0 mmol）。 / L; n = 620）或3类（> 11 mmol / L; n = 279）。使用Kaplan-Meier方法估算事件发生率。进行了3年随访的里程碑式生存分析，并将里程碑设置为30天。时间延长的Cox回归用于评估入院血糖水平的预测值。此外，对入院时已知的糖尿病状况进行了分层分析。第1类的30天死亡率为2.4％，第2类为6％，第3类为22％（p <0.01）。 30天存活者的三年死亡率在1类中为5.9％，在2类中为8.2％，在3类中为7.1％（p = 0.27）。入院时的血糖水平是30天死亡率的有力预测指标：无糖尿病的患者，每增加1 mmol / L，危险就增加14％（危险比1.14，95％置信区间1.09至1.19，p <0.01），在糖尿病患者中降低12％（危险比1.12，95％置信区间1.05至1.19，p <0.01），在整个队列中降低13％（危险比1.13，95％置信区间1.09至1.17，p <0.01） 。 30天后，入院时葡萄糖水平丧失了预测价值。总之，在患有和没有糖尿病的患者中，入院时的血糖水平是早期而非晚期死亡率的独立预测因子。

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