Initial Serum Glucose Level Points to Outcome After MI

The first serum glucose level measured in the emergency department is an independent prognostic factor in patients who have sustained a first acute myocardial infarction, researchers report. Dr. Kuo-Liong Chien of the National Taiwan University, Taipei and colleagues note that the initial glucose level in the emergency department shows the early glucose response to acute myocardial infarction and is not influenced by glucose-containing solutions or treatment by the referring institution.

To gain further information on the prognostic value of this parameter, the researchers retrospectively studied 198 MI patients. Of this group, 94 had a normal glucose level (less than 140 mg/dL), 53 had an intermediate level (140 to 200 mg/dL) and the remaining 51 had a level of 200 mg/dL or more.

In total, 18% of patients in the normal group had at least one adverse event in the first month post-MI. The corresponding proportion in the other two groups was 40%.

The adjusted odds ratio for adverse events in the first month was 3.87 in the intermediate group and 5.16 in the high level group, compared to the normal level group.

Mortality at 1 year was 3% in the normal group, 15% in the intermediate group and 18% in the high glucose level group.
Dr. Chien stated that, “after a first myocardial infarction, it appears that the initial glucose level measured in the emergency department may be an important prognostic factor in determining cardiovascular outcome."

Ann Emerg Med 2007;49:618-626.

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