Author/Authors :
Bhadriraju، نويسنده , , Satish and Ray، نويسنده , , Kausik K. and DeFranco، نويسنده , , Anthony C. and Barber، نويسنده , , Kim and Bhadriraju، نويسنده , , Padmini and Murphy، نويسنده , , Sabina A. and Morrow، نويسنده , , David A. and McCabe، نويسنده , , Carolyn H. and Gibson، نويسنده , , C. Michael and Cannon، نويسنده , , Christopher P. and Braunwald، نويسنده , , Eugene، نويسنده ,
Abstract :
Hyperglycemia in the context of acute coronary syndrome (ACS) is a common observation, and existing data suggest that high glucose levels are associated with increased in-hospital mortality. We assessed the relation between random glucose and long-term mortality in 9,020 patients with ACS who were enrolled in the OPUS-TIMI 16 trial. A significant relation between glucose level and 10-month mortality was observed (2.7% in quartile 1 vs 7.0% in quartile 4, p <0.0001). After multivariable adjustment for co-morbidity, which included history of diabetes, this relation remained significant (quartile 4 vs 1, hazard ratio 1.70, 95% confidence interval 1.16 to 2.50, p = 0.006). These observations were similar in the TACTICS-TIMI 18 trial. In addition, we observed that B-type natriuretic peptide and troponin I levels increased across glucose quartiles in the OPUS-TIMI 16 trial (p values for trend = 0.002 and 0.0001, respectively) and the TACTICS-TIMI 18 trial (p values for trend = 0.006 and 0.0001, respectively). High blood glucose during ACS is an independent predictor of long-term mortality and is significantly correlated with prognostic biomarkers. Glucose levels during ACS may be an important addition to the risk stratification of patients with ACS and a potentially important target for therapy.
