Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry

Study objectives To investigate the association between admission blood glucose levels and 28-day mortality as well as in-hospital complications in older patients with incident acute myocardial infarction (AMI) undergoing modern treatment.Methods From a German population-based regional MI registry,...

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Main Authors: Christa Meisinger, Annette Peters, Jakob Linseisen, Margit Heier, Christian Thilo, Konstantinos Volaklis, Temur Mamadjanov, Dennis Freuer, Ute Amann, B Kuch
Format: Article
Language:English
Published: BMJ Publishing Group 2021-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/6/e046641.full
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author Christa Meisinger
Annette Peters
Jakob Linseisen
Margit Heier
Christian Thilo
Konstantinos Volaklis
Temur Mamadjanov
Dennis Freuer
Ute Amann
B Kuch
author_facet Christa Meisinger
Annette Peters
Jakob Linseisen
Margit Heier
Christian Thilo
Konstantinos Volaklis
Temur Mamadjanov
Dennis Freuer
Ute Amann
B Kuch
author_sort Christa Meisinger
collection DOAJ
description Study objectives To investigate the association between admission blood glucose levels and 28-day mortality as well as in-hospital complications in older patients with incident acute myocardial infarction (AMI) undergoing modern treatment.Methods From a German population-based regional MI registry, 5530 patients (2016 women), aged 65–84 years, hospitalised with an incident AMI between 1 January 2009 and 31 December 2016 were included in the study. Multivariable logistic regression models were used to assess the associations between admission blood glucose and 28-day mortality as well as in-hospital complications after AMI. Analyses stratified according to age, diabetes and type of infarction (ST-elevation MI (STEMI)/non-STEMI) were conducted.Results The adjusted ORs for the association between admission blood glucose and 28-day mortality in young-old (65–74 years) and old (75–84 years) patients with AMI were 1.40 (95% CI: 1.21 to 1.62) and 1.21 (95% CI: 0.98 to 1.50) per 1 SD increase in admission blood glucose, respectively. Furthermore, higher admission blood glucose was related to case fatality irrespective of the diabetes status and type of infarction only in the under-75 group. For the patients aged 75–84 years, it was only true for those without diabetes and STEMI. Admission blood glucose was also associated with major cardiac complications in both age groups.Conclusion Admission blood glucose was significantly associated with 28-day case fatality in patients with AMI aged 65–74 years but not 75–84 years; furthermore, in both age groups there was an increased risk of major complications. It seems that admission glucose may play a rather minor role in terms of case fatality in higher aged patients with AMI.
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spelling doaj-art-9d5a05f3dcef4069b9f921ddee94e7172024-11-20T00:15:09ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-046641Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction RegistryChrista Meisinger0Annette Peters1Jakob Linseisen2Margit Heier3Christian Thilo4Konstantinos Volaklis5Temur Mamadjanov6Dennis Freuer7Ute Amann8B Kuch92 Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Augsburg, Germany3 Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center for Health and Environment, Neuherberg, Germanyunit head3 Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center for Health and Environment, Neuherberg, Germany7 Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany2 Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Augsburg, Germany1 Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University of Munich, Munchen, GermanyEpidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany5 Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Munchen, German Research Center for Health and Environment, Neuherberg, Germany6 Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, GermanyStudy objectives To investigate the association between admission blood glucose levels and 28-day mortality as well as in-hospital complications in older patients with incident acute myocardial infarction (AMI) undergoing modern treatment.Methods From a German population-based regional MI registry, 5530 patients (2016 women), aged 65–84 years, hospitalised with an incident AMI between 1 January 2009 and 31 December 2016 were included in the study. Multivariable logistic regression models were used to assess the associations between admission blood glucose and 28-day mortality as well as in-hospital complications after AMI. Analyses stratified according to age, diabetes and type of infarction (ST-elevation MI (STEMI)/non-STEMI) were conducted.Results The adjusted ORs for the association between admission blood glucose and 28-day mortality in young-old (65–74 years) and old (75–84 years) patients with AMI were 1.40 (95% CI: 1.21 to 1.62) and 1.21 (95% CI: 0.98 to 1.50) per 1 SD increase in admission blood glucose, respectively. Furthermore, higher admission blood glucose was related to case fatality irrespective of the diabetes status and type of infarction only in the under-75 group. For the patients aged 75–84 years, it was only true for those without diabetes and STEMI. Admission blood glucose was also associated with major cardiac complications in both age groups.Conclusion Admission blood glucose was significantly associated with 28-day case fatality in patients with AMI aged 65–74 years but not 75–84 years; furthermore, in both age groups there was an increased risk of major complications. It seems that admission glucose may play a rather minor role in terms of case fatality in higher aged patients with AMI.https://bmjopen.bmj.com/content/11/6/e046641.full
spellingShingle Christa Meisinger
Annette Peters
Jakob Linseisen
Margit Heier
Christian Thilo
Konstantinos Volaklis
Temur Mamadjanov
Dennis Freuer
Ute Amann
B Kuch
Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
BMJ Open
title Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
title_full Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
title_fullStr Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
title_full_unstemmed Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
title_short Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry
title_sort admission glucose level and short term mortality in older patients with acute myocardial infarction results from the kora myocardial infarction registry
url https://bmjopen.bmj.com/content/11/6/e046641.full
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