Glycemia and inflammatory markers in acute coronary syndrome: association with late post-hospital outcomes.

Background: Glycemia and inflammatory markers were associated with clinical outcomes in patients with acute coronary syndrome (ACS).

Objectives: To evaluate the role of glycemia and inflammatory markers as predictors of late cardiovascular outcomes after ACS.

Methods: One hundred and ninety-nine ACS patients of a Coronary Care Unit were included, from March to November 2002. They were reassessed clinically after approximately 3 years. Clinical variables, glycemia, CRP and fibrinogen were evaluated as event and mortality predictors. Statistical analyses included Cox multivariate analysis and survival curves (Kaplan-Meier).

Results: At admission, 16.7% had normal glycemia. After 3 years, this proportion increased to 55.2%; the 40.6% who belonged to the borderline category decreased to 27.1%; the 42.7% with elevated glycemia decreased to 17.7%. Glycemia was not associated with the development of major cardiovascular events (MACE) and mortality at follow-up ( approximately 3 years). Considering MACE, CRP (p<0.001), but not fibrinogen, was predictive in bivariate analysis. Regarding mortality, both fibrinogen (p=0.020) and CRP (p=0.008) were predictive in bivariate analysis.

Conclusion: Glycemia was not associated with late mortality after ACS, but inflammatory markers were, suggesting that these are more sensitive markers to predict events in long-term. Moreover, glucose intolerance prevalence is lower in the follow-up after the ACS episode.