Skip to main content

Newly diagnosed abnormal glucose tolerance determines post-MI prognosis in patients with hospital related hyperglycaemia but without known diabetes

Chattopadhyay, Sudipta; George, Anish; John, Joseph; Sathyapalan, Thozhukat

Authors

Sudipta Chattopadhyay

Anish George

Joseph John

Thozhukat Sathyapalan



Abstract

Aims
Investigate if abnormal glucose tolerance (AGT) affects post-myocardial infarction (MI) prognosis in patients with hospital-related hyperglycaemia (HRH) but without known diabetes mellitus (KDM).

Methods
Post-MI survivors without KDM underwent pre-discharge oral glucose tolerance test. Cardiovascular death and non-fatal re-infarction (MACE) were recorded. We compare the ability of admission (APG), fasting (FPG) and 2 h post-load (2 h-PG) plasma glucose to predict MACE in patients with (HRH) and without HRH (NoHRH).

Results
50.2% and 73% of NoHRH and HRH had AGT respectively. MACE occurred in 19.5% and 18.1% in HRH and NoHRH groups. MACE-free survival was lower in patient with AGT in both groups (NoHRH: HR 1.82, 95% CI 1.19–2.78, p = 0.005; HRH: HR 2.48, 95% CI 1.24–4.96, p = 0.010). AGT predicted MACE-free survival (NoHRH: HR 1.60, 95% CI 1.02–2.51, p = 0.042; HRH: HR 3.09, 95% CI 1.07–8.94, p = 0.037). 2 h-PG, but not FPG or APG, independently predicted MACE free survival (NoHRH: HR 1.17, 95% CI 1.07–1.27, p ≤0.001 and HRH: HR 1.18, 95% CI 1.03–1.37, p = 0.020). Addition of AGT and 2 h-PG, not FPG or APG, improved net reclassification of events in both groups.

Conclusion
Post-MI prognosis is worse with AGT irrespective of presence of HRH. 2 h-PG, predicts prognosis in HRH and NoHRH groups.

Journal Article Type Article
Publication Date 2020-01
Journal Journal of Diabetes and its Complications
Print ISSN 1056-8727
Publisher Elsevier
Peer Reviewed Peer Reviewed
Pages 107518
APA6 Citation Chattopadhyay, S., George, A., John, J., & Sathyapalan, T. (2020). Newly diagnosed abnormal glucose tolerance determines post-MI prognosis in patients with hospital related hyperglycaemia but without known diabetes. Journal of Diabetes and its Complications, 107518. https://doi.org/10.1016/j.jdiacomp.2019.107518
DOI https://doi.org/10.1016/j.jdiacomp.2019.107518
Keywords Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology; Stress hyperglycaemia; Hospital related hyperglycaemia; Abnormal glucose tolerance; Diabetes; Myocardial infarction

This file is under embargo due to copyright reasons.

Contact T.Sathyapalan@hull.ac.uk to request a copy for personal use.




Downloadable Citations