Admission Glucose and Mortality in Elderly Patients Hospitalized With Acute Myocardial Infarction: Implications for Patients With and Without Recognized Diabetes
Abstract
Background The relationship between admission glucose levels and outcomes in older diabetic and nondiabetic patients with acute myocardial infarction is not well defined. Methods and results We evaluated a national sample of elderly patients (n=141,680) hospitalized with acute myocardial infarction from 1994 to 1996. Admission glucose was analyzed as a categorical ( 110 to 140, >140 to 170, >170 to 240, >240 mg/dL) and continuous variable for its association with mortality in patients with and without recognized diabetes. A substantial proportion of hyperglycemic patients (eg, 26% of those with glucose >240 mg/dL) did not have recognized diabetes. Fewer hyperglycemic patients without known diabetes received insulin during hospitalization than diabetics with similar glucose levels (eg, glucose >240 mg/dL, 22% versus 73%; P 240 mg/dL, 10% to 39%) compared with diabetics (range, 16% to 24%; P for interaction 110 to 140 mg/dL: hazard ratio [HR], 1.17; 95% CI, 1.11 to 1.24; to glucose >240 mg/dL: HR, 1.87; 95% CI, 1.75 to 2.00). In contrast, among diabetic patients, greater mortality risk was observed only in those with glucose >240 mg/dL (HR, 1.32; 95% CI, 1.17 to 1.50 versus glucose Conclusions Elevated glucose is common, rarely treated, and associated with increased mortality risk in elderly acute myocardial infarction patients, particularly those without recognized diabetes.
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A population study of patients admitted to hospital for acute myocardial infarction found that individuals with glucose levels at the extreme ends of the spectrum had higher mortality rates at hospital admission and at 30 days and one year after the event than those with normal blood glucose levels.
“A population study of patients admitted to hospital for acute myocardial infarction found that individuals with glucose levels at the extreme ends of the spectrum (high and low) had higher mortality rates at hospital admission and at both 30 days and one year after the event than those with normal blood glucose levels.”
From The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: Retrospective epidemiological analysis of the ACCORD study (2010) · cites this paper as [8]
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“A population study of patients admitted to hospital for acute myocardial infarction found that individuals with glucose levels at the extreme ends of the spectrum (high and low) had higher mortality rates at hospital admission and at both 30 days and one year after the event than those with normal blood glucose levels…”
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- Authors
- Kosiborod, M., Rathore, S. S., Inzucchi, S. E., Masoudi, F. A., Wang, Y., Havranek, E. P., & Krumholz, H. M.
- Affiliations
- Denver Health Medical Center (US)
- ORCID
- Venue
- Circulation
- Published
- 2005-06-14
- Volume
- 111
- Issue
- 23
- Pages
- 3078-3086
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2132519575
- Cited by
- 666
- References
- 4
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 36 · 2023: 24 · 2022: 24 · 2021: 27 · 2020: 27 · 2019: 24 · 2018: 29 · 2017: 25 · 2016: 25 · 2015: 45 · 2014: 45 · 2013: 36 · 2012: 46
- FWCI
- 16.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Robert Wood Johnson Foundation
- National Institutes of Health
- National Institute on Aging (K08-AG01011, K08AG001011)
- National Institute of General Medical Sciences (GM07205, T32GM007205)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- admission blood glucose, hyperglycemia, acute myocardial infarction, elderly patients, mortality, diabetes mellitus, insulin therapy, undiagnosed diabetes, 30-day mortality, one-year mortality, hospitalized patients, glycemic control, risk stratification, risk communication
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Female, Humans, Hyperglycemia, Male, Myocardial Infarction, Patient Admission, Survival Rate, Case-Control Studies, Treatment Outcome, Hospital Mortality
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