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

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.

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, 34(4), Article 107518. https://doi.org/10.1016/j.jdiacomp.2019.107518

• Journal Article Type: Article
• Acceptance Date: Dec 28, 2019
• Online Publication Date: Jan 2, 2020
• Publication Date: 2020-04
• Deposit Date: Jan 12, 2020
• Publicly Available Date: Jan 3, 2021
• Journal: Journal of Diabetes and its Complications
• Print ISSN: 1056-8727
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 34
• Issue: 4
• Article Number: 107518
• DOI: https://doi.org/10.1016/j.jdiacomp.2019.107518
• Keywords: Stress hyperglycaemia; Hospital related hyperglycaemia; Abnormal glucose tolerance; Diabetes; Myocardial infarction
• Public URL: https://hull-repository.worktribe.com/output/3361598
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S1056872719310505?via%3Dihub
• Contract Date: Jan 12, 2020