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The relation between hyperglycemia on admission and the mortality in short term after an acute coronary syndrome is a well-known notion that has been reported before and after the era of coronary revascularisation in particular among non-diabetic patients. The objective is to analyse the effect of coronary reperfusion in the acute phase on the relation between the glycaemia on admission and the in-hospital mortality of STEMI in non-diabetic patients.
A prospective, multicentric study about 1222 non-diabetic patients (HBA1C< 6.5%) admitted during the first 24 hours of a STEMI. The mean age of the population was 60.28 yo ± 13 yo, the mean glycemia on admission was 1.39 g/l ± 0.333, 56.2% of the patients benefit from early coronary reperfusion, the in-hospital mortality was 7.2%.
The results showed a linear correlation between the level of glycemia on admission and in-hospital mortality, an increase of 10mg/l of serum glucose was associated to an increased mortality of 2,6%(2,0-3,3), p<0,001. The mortality was higher in the population of patients who haven’t receive any reperfusion therapy 12,2% versus 3,3% (p<0,001). But the impact of the glycemia on-admission seems more important on the population of reperfused patient adjusted OR à 5,2 (1,5-17,5), p=0,008 versus adjusted OR 2,7 (1,3-5,38), p=0,005.
Hyperglycemia on admission is an independent predictive factor of short term mortality in non diabetic patients during the acute phase of STEMI, its impact is more important in patients who benefit from a revascularisation therapy at an early stage.
CORONARY: Acute Myocardial Infarction