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The prognostic role of in-hospital peak glycemia in stemi patients with and without diabetes

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Abstract

Due to the lack of appropriately designed randomized trials, the definitive answer in regard to the prognostic role of in-hospital glucose values in patients with AMI is lacking. We prospectively assessed the prognostic role of in-hospital peak glycemia (≤1.40, 141–180 and >180 g/l) in 611 consecutive STEMI patients (diabetic and without previously known diabetes) submitted to percutaneous coronary intervention. One hundred and fifteen (18.8%) were diabetic and the remaining 496 (81.2%) without previously known diabetes. At multivariable logistic regression analysis, peak glycemia was an independent predictor for in-ICCU death in the overall population and in patients without previously known diabetes. At follow-up, in the overall population (as well as in diabetic and non-diabetic patients), patients with peak glycemia >1.8 g/l showed the lowest survival rate, those with peak glycemia <1.4 g/l the highest and patients with peak glycemia >1.4 and <1.8 g/l intermediate survival rates. In-hospital peak glycemia is an independent predictor for early death in patients without previously known diabetes, but not in diabetic STEMI patients. At follow-up, in-hospital peak glycemia is able to affect long-term survival in diabetic and non-diabetic patients. Our data underscore strongly suggest that different glucose targets and thresholds may be pursued in diabetic and non-diabetic STEMI patients.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy

    Chiara Lazzeri, Serafina Valente, Marco Chiostri, Paola Attanà, Claudio Picariello & Gian Franco Gensini

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  1. Chiara Lazzeri
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  2. Serafina Valente
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  3. Marco Chiostri
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  4. Paola Attanà
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  5. Claudio Picariello
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  6. Gian Franco Gensini
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Correspondence to Chiara Lazzeri.

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Lazzeri, C., Valente, S., Chiostri, M. et al. The prognostic role of in-hospital peak glycemia in stemi patients with and without diabetes. Acta Diabetol 49, 379–386 (2012). https://doi.org/10.1007/s00592-011-0343-4

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  • DOI: https://doi.org/10.1007/s00592-011-0343-4

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