Study On The Association Between Fasting Glucose And Cardiovascular Events With Acute Myocardial Infarction.

Background:.In recent years, the mortality of acute myocardial infarction(AMI)has been present the obvious up-trend in our country. Epidemiological data indicate that up to 60 % of patients with coronary artery disease have abnormalities of glucose metabolism. The recent research concentrated on the connection of impaired glucose tolerance with long-term prognoses to acute myocardial infarction, as well as on the influence of intensive insulin treatment on the prognoses of acute myocardial infarction etc. The study about the association between fasting glucose and cardiovascular events in-hospital is limited.0bjective:To examine the association between fasting glucose and cardiovascular events in hospital, evaluate the effect of fasting glucose to the short-term prognosis after acute myocardial infarction, so that to provide the academic foundation for clinical therapy. Methods:The 310 patients were divided into two groups according to fasting glucose in the next day: groupⅠ, fasting glucose≤6.0mmol/L ; groupⅡ, fasting glucose >6.0mmol/L or previously diagnosed diabetes mellitus. Record the cardiovascular events of the two group in hospital (congestive heart failure, angina after myocardial infarction, severe arrhythmias, Cardiogenic shock, cardiac death), compare the prognosis.Results:⑴The following morbidity of cardiovascular events in groupⅡwere significantly higher than those in groupⅠ: severe arrhythmias(30.4% vs 14.5%, p<0.05), congestive heart failure(24.6% vs 7.6%, p<0.01), angina after myocardial infarction,(15.9% vs 5.8%, p<0.05), Cardiogenic shock (14.5% vs 3.5%, p<0.01). there were no significant differences between the groups in morbidity of cardiac death(p=0.05).⑵logistic regression models revealed the level of fasting glucose was an important risk factor in congestive heart failure, angina after myocardial infarction and cardiac death, respectively(p<0.05,OR 1.115; p<0.01,OR 1.103; p<0.01,OR 1.148).Heart function (killip class) was an important risk factor in severe arrhythmias, Cardiogenic shock,cardiac death, respectively(p<0.01,OR 3.019; p<0.01,OR 3.552; p<0.05, OR 2.099).Conclusion:⑴This study showed the patients with abnormal glucose metabolism had a high morbidity of cardiovascular events in short term.⑵Fasting glucose was an important influence factor in congestive heart failure, angina after myocardial infarction and cardiac death in short term.⑶Heart function (killip class)was an important influence factor in severe arrhythmias, Cardiogenic shock and cardiac death in short term.