Revision: prognostic impact of baseline glucose levels in acute myocardial infarction complicated by cardiogenic shock—a substudy of the IABP-SHOCK II-trial View Full Text


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Article Info

DATE

2018-06

AUTHORS

Amr Abdin, Janine Pöss, Georg Fuernau, Taoufik Ouarrak, Steffen Desch, Ingo Eitel, Suzanne de Waha, Uwe Zeymer, Michael Böhm, Holger Thiele

ABSTRACT

BACKGROUND: Limited data from observational retrospective studies suggest an association between glucose levels and prognosis of patients with cardiogenic shock (CS). The aim of this study was to investigate the prognostic role of glucose at admission in patients with acute myocardial infarction (AMI) complicated by CS included in the largest CS trial to date, the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial. METHODS AND RESULTS: In the IABP-SHOCK II-trial, patients with CS complicating AMI undergoing early revascularization were randomized to a therapy with vs. without IABP support. Primary and secondary endpoints were mortality within 30 days and 1 year, respectively. Glucose levels were examined at admission. Glucose levels were available in 513 patients. In total, 33.7% of the patients had known diabetes. Patients with diabetes had higher glucose levels compared to those without diabetes (median [interquartile range (IQR)] 13.1 mmol/L [IQR 9.5-18.3] vs. 10.8 mmol/L [IQR 7.8-15.4], p = 0.0003). Patients with glucose concentrations above the median (11.5 mmol/L) had higher 30-day and 1-year mortality compared to those below the median (47.7 vs. 36.5%, p = 0.004; 57.7 vs. 47.1%, p = 0.011, respectively). This negative prognostic impact of increased glucose levels remained significant in multivariate adjustment and was not influenced even after adjustment for the presence or absence of diabetes mellitus. CONCLUSIONS: In patients with CS complicating AMI, increased glucose concentration at admission was an independent predictor for mortality at 30-days and 1-year, independently of the diabetic state. More... »

PAGES

517-523

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-018-1213-7

DOI

http://dx.doi.org/10.1007/s00392-018-1213-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100893932

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29423774


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    "description": "BACKGROUND: Limited data from observational retrospective studies suggest an association between glucose levels and prognosis of patients with cardiogenic shock (CS). The aim of this study was to investigate the prognostic role of glucose at admission in patients with acute myocardial infarction (AMI) complicated by CS included in the largest CS trial to date, the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial.\nMETHODS AND RESULTS: In the IABP-SHOCK II-trial, patients with CS complicating AMI undergoing early revascularization were randomized to a therapy with vs. without IABP support. Primary and secondary endpoints were mortality within 30\u00a0days and 1 year, respectively. Glucose levels were examined at admission. Glucose levels were available in 513 patients. In total, 33.7% of the patients had known diabetes. Patients with diabetes had higher glucose levels compared to those without diabetes (median [interquartile range (IQR)] 13.1\u00a0mmol/L [IQR 9.5-18.3] vs. 10.8\u00a0mmol/L [IQR 7.8-15.4], p\u2009=\u20090.0003). Patients with glucose concentrations above the median (11.5\u00a0mmol/L) had higher 30-day and 1-year mortality compared to those below the median (47.7 vs. 36.5%, p\u2009=\u20090.004; 57.7 vs. 47.1%, p\u2009=\u20090.011, respectively). This negative prognostic impact of increased glucose levels remained significant in multivariate adjustment and was not influenced even after adjustment for the presence or absence of diabetes mellitus.\nCONCLUSIONS: In patients with CS complicating AMI, increased glucose concentration at admission was an independent predictor for mortality at 30-days and 1-year, independently of the diabetic state.", 
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