"Study of Blood Glucose Level on Admission As Potential Indicator for Mortality in Non-Diabetic Patients with Acute Myocardial Infarction"

Background: In recent years, much attention has been given to the evidence that the concomitant occurrence of hyperglycemia in patients with an acute myocardial infarction (MI) enhances the risk of mortality and morbidity, whether the patient has diabetes or not. Objectives: To analyze impact of admission glycaemia on hospital stay mortality in non-diabetic patients presenting with acute myocardial infarction. Methods: The study was conducted on 50 cases of AMI admitted at Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India during the year 2015-2016. The cases were divided into 4 groups (group I to IV) based on admission RBS. There were 14 patients in Group I (admission RBS 167mg %). All cases were subjected to investigation, and in-hospital complications were noted. They were also followed up for 30 days. In hospital complications and 30-day mortality was analyzed using appropriate statistical methods across the groups (I- IV). Results: Of the 50 cases, all had ST segment elevation myocardial infarction. Age and sex were comparable between the groups but patients aged >60 years were more common in group IV. With progressive rise in admission RBS (Groups I to IV), there was a progressive drop in mean systolic BP (p=0.000302*), mean diastolic BP (p=0.0493*) and LVEF (p=0.0002*), greater occurrence of arrhythmias (p=0.011*) and subsequent development of cardiogenic shock (0.008*). Patients with high admission RBS were also found to have higher admission Killip class (0.01511*) and increased incidence of subsequent deterioration of Killip class by ≥2 classes (0.029106*) during the hospital stay. The 30 day- mortality occurrence increased as we progressed from group I to IV (p=0.12845*). Conclusion: In our study, overall in-hospital complications were more common in subjects with high admission RBS. There was a positive linear correlation between admission RBS and 30-day mortality. Our study emphasizes that proper management strategy of glycemic state in patients with acute myocardial infarction may reduce the morbidity and mortality associated with acute hyperglycemia.