Major adverse cardiovascular events in patients after acute myocardial infarction treated invasively and different patterns of glucometabolic disturbances evaluated at mid-term follow-up

Paweł Francuz; Tomasz Podolecki; Monika Kozieł; Zbigniew Kalarus; Jacek Kowalczyk

doi:10.20883/jms.2017.160

Authors

Paweł Francuz Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases
Tomasz Podolecki Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases
Monika Kozieł Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases
Zbigniew Kalarus Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases
Jacek Kowalczyk Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases

DOI:

https://doi.org/10.20883/jms.2017.160

Keywords:

abnormal glucose tolerance, coronary artery disease, mortality, oral glucose tolerance test, heart failure hospitalization

Abstract

Objective: To assess the impact of glucometabolic status (GS) evaluated at hospital discharge and at mid-term follow-up visit (FU-visit) on major adverse cardiovascular events (MACE) in patients (pts) with acute myocardial infarction (AMI) treated invasively.

Material and Methods: Study encompassed 368 AMI-pts treated invasively, in whom GS was assessed by 2-hour post load glycemia at hospital discharge and at FU-visit after 6 months. Patients were divided into two groups with respect to GS at hospital discharge: abnormal glucose tolerance (AGT, n=149), normal glucose tolerance (NGT, n=219). Each of those groups was divided into two subgroups with respect to GS at FU-visit: persistent AGT (pAGT, n=101), transient AGT (tAGT, n=48), newly detected AGT (newAGT, n=114), persistent NGT (pNGT, n=105). Median follow-up duration after FU-visit was 24.5 months.

Results: There was a trend towards more subjects with MACE in AGT than NGT group (24.2% vs. 16%; p=0.051). More AGT-pts were hospitalized due to decompensated heart failure (6% vs. 0.5%; p=0.002). However, there were no significant differences in MACE between subjects with pAGT and tAGT, including heart failure hospitalizations. Among NGT-pts there were no significant differences in particular MACE between newAGT-pts and pNGT-pts.

Conclusions: In AMI-pts treated invasively, who had abnormal glucose tolerance at hospital discharge, the improvement in glucometabolic status after 6 months was not related to lower risk of hospitalization due to decompensated heart failure.

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