Admission hyperglycemia as an independent predictor of long-term prognosis in non-diabetic patients with acute myocardial infarction: a retrospective study.

AIMS The predictive value of admission hyperglycemia in the long-term prognosis of AMI patients is still controversial. We aim to investigate this value based on the diabetic status. METHODS We performed a multicenter, retrospective study on 1,288 AMI patients enrolled in 11 hospitals between March 2014 and June 2019 in Chengdu. The patients were classified into diabetics and non-diabetics groups, each was further divided into: hyperglycemia and non-hyperglycemia subgroups, according to the optimal cut-off value of the blood glucose to predict all-cause mortality during follow-up. The endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, vessel revascularization and non-fatal stroke. RESULTS In the follow-up of 15 months, we observed 210 (16.3%), 6 (0.5%), 57 (4.4%) and 34 (2.6%) cases of death, non-fatal MI, revascularization and non-fatal stroke, respectively. The optimal cut-off values of admission blood glucose for diabetics and non-diabetics to predict all-cause mortality during follow-up were 14.80 mmol/L and 6.77 mmol/L, respectively. We divided diabetics (n=331) into hyperglycemia (n=92) and non-hyperglycemia (n=239), and non-diabetics (n=897) into hyperglycemia (n=425) and non-hyperglycemia (n=472). The cumulative rates of all-cause death and MACCE of the patients in each hyperglycemia group was higher than that in the corresponding non-hyperglycemia group (p-value < 0.001). In non-diabetics, admission hyperglycemia was an independent predictor of all-cause mortality and MACCE. CONCLUSION Admission hyperglycemia was an independent predictor for long-term prognosis in non-diabetic AMI patients.