BG a major Risk factor for post MI (heart attacks) patients



B

Brad Sheppard

Guest
" High levels of blood glucose after hospital admission for
acute myocardial infarction (MI) are predictive of an
increased risk of mortality in patients with or without
known diabetes, according to Dutch researchers.

In the May 10th issue of the Archives of Internal
Medicine, Dr. Frans
C. Visser of VU University Medical Center, Amsterdam and
colleagues note that "recent data indicates a high
prevalence of abnormal glucose metabolism in patients
with unknown diabetes at the time of acute MI."

To investigate the predictive value of blood glucose
measurement, the researchers conducted a retrospective study
with prospective follow-up of 737 patients without and 100
with known diabetes.

During a median follow-up of 50 months, 208 non-diabetic
patients died
(28.2%) and 47 diabetic patients died (43.1%).

Each 18 mg/dL increase in blood glucose level was associated
with a 4% increase in mortality risk in non-diabetics and a
5% increase in diabetics.

Furthermore, of the previously non-diabetics, 101 had
admission blood glucose levels of 200 mg/dL or more and
their mortality (42.6%) was comparable to that of the
diabetics (43.1%).

Thus, the researchers conclude that "admission blood glucose
level after acute MI may be an important tool for risk
stratification at follow-up."

http://www.medscape.com/viewarticle/478610
 
"Brad Sheppard" <[email protected]> wrote in message
news:[email protected]...
> " High levels of blood glucose after hospital admission
> for acute myocardial infarction (MI) are predictive of an
> increased risk of mortality in patients with or without
> known diabetes, according to Dutch researchers.
>
> In the May 10th issue of the Archives of Internal
> Medicine, Dr. Frans
> C. Visser of VU University Medical Center, Amsterdam and
> colleagues note that "recent data indicates a high
> prevalence of abnormal glucose metabolism in patients
> with unknown diabetes at the time of acute MI."
>
> To investigate the predictive value of blood glucose
> measurement, the researchers conducted a retrospective
> study with prospective follow-up of 737 patients without
> and 100 with known diabetes.
>
> During a median follow-up of 50 months, 208 non-diabetic
> patients died
> (28.2%) and 47 diabetic patients died (43.1%).
>
> Each 18 mg/dL increase in blood glucose level was
> associated with a 4% increase in mortality risk in non-
> diabetics and a 5% increase in diabetics.
>
> Furthermore, of the previously non-diabetics, 101 had
> admission blood glucose levels of 200 mg/dL or more and
> their mortality (42.6%) was comparable to that of the
> diabetics (43.1%).
>
> Thus, the researchers conclude that "admission blood
> glucose level after acute MI may be an important tool for
> risk stratification at follow-up."
>
> http://www.medscape.com/viewarticle/478610

Thanks. What this would seem to be saying is that a lot of
people have diabetes and don't know it. Those that do,
whether they know it or not, are more like to die following
an MI. So they should test blood glucose. I'm surprised they
also did not test, or report, hemoglobin A1c.

Bill
 
Good point, Bill. Here's Dr. Mirkin's article from 2002 on the same
topic:
"HEART ATTACK: CHECK FOR DIABETES

Gabe Mirkin, M.D.

A study from Sweden shows that many people discover that
they are diabetic only after they have had a heart attack.
Researchers recorded blood sugar levels in men who had had
heart attacks and then did sugar tolerance tests at
discharge and three months later. They found that 35
percent had diabetic sugar tolerance tests at hospital
discharge and 40 percent had impaired sugar tolerance tests
three months later.

Therefore, 40 percent of people who have heart attacks are
diabetic, even though they may not know it. Many of the
diabetics had normal HBA1C blood tests, the standard test to
measure diabetic control. Furthermore, the patients who were
unknown diabetics had a much higher rate of sudden death
from their heart attacks than those who were not diabetic.
The authors recommend that all people with heart attacks be
tested for diabetes.

Lancet 2002; 359: 2140-44. "Glucose metabolism in patients
with acute myocardial infarction and no previous diagnosis
of diabetes mellitus: a prospective study"
http://www.drmirkin.com/heart/1221.html

> "Brad Sheppard" <[email protected]> wrote in
> message
> news:[email protected]...
> > " High levels of blood glucose after hospital admission
> > for acute myocardial infarction (MI) are predictive of
> > an increased risk of mortality in patients with or
> > without known diabetes, according to Dutch researchers.
> >
> > In the May 10th issue of the Archives of Internal
> > Medicine, Dr. Frans
> > C. Visser of VU University Medical Center, Amsterdam and
> > colleagues note that "recent data indicates a high
> > prevalence of abnormal glucose metabolism in patients
> > with unknown diabetes at the time of acute MI."
> >
> > To investigate the predictive value of blood glucose
> > measurement, the researchers conducted a retrospective
> > study with prospective follow-up of 737 patients without
> > and 100 with known diabetes.
> >
> > During a median follow-up of 50 months, 208 non-diabetic
> > patients died
> > (28.2%) and 47 diabetic patients died (43.1%).
> >
> > Each 18 mg/dL increase in blood glucose level was
> > associated with a 4% increase in mortality risk in non-
> > diabetics and a 5% increase in diabetics.
> >
> > Furthermore, of the previously non-diabetics, 101 had
> > admission blood glucose levels of 200 mg/dL or more and
> > their mortality (42.6%) was comparable to that of the
> > diabetics (43.1%).
> >
> > Thus, the researchers conclude that "admission blood
> > glucose level after acute MI may be an important tool
> > for risk stratification at follow-up."
> >
> > http://www.medscape.com/viewarticle/478610
>
> Thanks. What this would seem to be saying is that a
> lot of people have diabetes and don't know it. Those
> that do, whether they know it or not, are more like to
> die following an MI. So they should test blood
> glucose. I'm surprised they also did not test, or
> report, hemoglobin A1c.
>
> Bill
 
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