Impact Of Admission Glycemia On 30- Day Mortality in non Diabetic C Patient’ S Admitted For Myocardial Infarction – A One Year Cross Sectional Study

Abstract

Background and Objectives : In recent years, much attention has been given to the evidence that the concomitant occurrence of hyperglycaemia in patients admitted to intensive care units with an acute myocardial infarction ( MI ) enhances the risk of mortality and morbidity, whether the patient has diabetes or not. This study aims at exploring the association between the admission glycemic status and 30 day- mortality in acute myocardial infarction in non diabetics. Methods: The study was conducted on 60 cases of AMI admitted at KLE’s Dr Prabhakar Kore Hospital &MRC Belgaum during the year 2007-08. The cases were divided into 4 groups ( group I to IV ) based on admission RBS. There were 16 patients in group I ( admission RBS < 120mg% ) , 12patients in group II ( admission RBS 120- 140mg% ) , 14 patients in group III ( admission RBS 140- 167mg% ) , 18 patients in group IV ( admission RBS > 167mg% ) . All cases were subjected to investigation, and in-hospital complications were noted. They were also followed up for 30 days. In hospital complications and 30-day mortality was analyzed using appropriate statistical methods across the groups ( I- IV ) . Results: Of the 60 cases, all had ST segment elevation myocardial infarction. Age and sex were comparable between the groups but patients aged >60 years were more common in group IV. With progressive rise in admission RBS ( Groups I to IV ) , there was a progressive drop in systolic BP ( P= 0.042 ) and LVEF ( P= 0.001) , and greater occurrence of arrhythmias ( P= 0.003) and subsequent development of cardiogenic shock ( P= 0.006 ) . Patients with high admission RBS were also found to have higher IX admission Killip class ( Killip class I - P= 0.018, Killip class II - P= 0.016) and increased incidence of subsequent deterioration of Killip class by ≥2 classes ( P= 0.001) during the hospital stay. The 30 day- mortality occurrence increased as we progressed from group I to IV ( P= 0.008) . Conclusion: In our study overall in hospital complications were more common in subjects with high admission RBS. There was a positive linear correlation between admission RBS and 30-day mortality.