Prognostic Importance of Admission Plasma Glucose in Diabetic and Non-diabetic Patients with Acute Myocardial Infarction

SUMMARY We assessed the relationship of plasma glucose concentrationsmeasured on admission to mortality during the acute phase ofmyocardial infarction in 143 diabetic patients and 277 patientswithout a previous history of diabetes. Mortality in hospital in patients not known to have diabetesincreased significantly from 4 per cent in patients with admissionplasma glucose below 8 mmol/1 to 35 per cent in patients withadmission plasma glucose above 11 mmol/1. In diabetic patientsthe mortality increased with increasing admission plasma glucosebut the difference was not significant. In patients with diabetesmean admission plasma glucose levels of the survivors and thosewho died were similar, whilist in the non-diabetic group themean plasma glucose levels of the patients who did not survivewere significantly higher than those of the survivors. Stepwiselogistic regression analyses identified admission plasma glucoselevel as an important predictor of mortality in the non-diabeticgroup but not in the diabetic patients. Plasma glucose level on admission is an important prognosticindicator in non-diabetic patients, in that hyperglycaemia isassociated with a higher mortality. In diabetic patients a clearrelationship between admission plasma glucose and mortalitywas not demonstrated.