Prognostic Impact of Stress Hyperglycemia in Non-Diabetic Patients Treated with Successful Primary Percutaneous Coronary Intervention

Background: Stress hyperglycemia (SH) is common is patients with ST-elevation myocardial infraction (STEMI). The aims of the study were to analyze the impact of SH on the incidence of all-cause mortality and major adverse cardiovascular events (MACE-cardiovascular death, non-fatal reinfarction, target vessel revascularization and stroke) in STEMI patients without diabetes mellitus (DM) who have been treated successfully with primary PCI (pPCI). Method: we analyzed 2,362 STEMI patients treated with successful pPCI (post-procedural flow TIMI=3) and without DM and cardiogenic shock at admission. SH was defined as plasma glucose level above 7.8mmol/L at admission. The follow-up period was 8 years. Results: Incidence of SH was 26.9%. Eight-year all-cause mortality and MACE rates were significantly higher in patients with SH, as compared to patients without SH (9.7% vs 4.2%, p<0.001 and 15.7% vs 9.4%, p<0.001). SH was an independent predictor of short and long-term all-cause mortality (HR 2.19, 95%CI 1.16-4.18 and HR 1.99, 95%CI 1.03-3.85) and MACE (HR 1.49, 95%CI 1.03-2.03 and HR 1.35, 95%CI 1.03-1.89). Conclusion: Despite successful revascularization, SH at admission was an independent predictor of short-term and long-term (up to eight years) all-cause mortality and MACE, but its negative prognostic impact was stronger in short-term follow-up.