Background: The prognostic effect of admission blood glucose (ABG) for patients with acute myocardial infarction (AMI) has not been well validated, especially in patients with diabetes. We performed this study to assess the predictive value of ABG for all-cause mortality in AMI patients with different glucose metabolism status.
Methods: We evaluated a total of 6,892 AMI patients from the prospective, nationwide, multicenter CAMI registry, of which 2,820 had diabetes, 2,011 had pre-diabetes, and 2,061 had normal glucose regulation (NGR). Patients were divided into high ABG and low ABG groups according to the optimal cutoff values of ABG to predict 2-year mortality for patients with diabetes, pre-diabetes and NGR, respectively. The primary endpoint was all-cause mortality.
Results: The optimal cutoff values of ABG for predicting 2-year mortality was 9.0mmol/l, 7.2mmol/l and 6.2mmol/l for patients with diabetes, pre-diabetes and NGR, respectively. Overall, the risk of all-cause mortality in high ABG group was significantly increased compared with that in low ABG group among patients with diabetes (15.2% . 8.9%; hazard ratio [HR] 1.787, 95% confidence interval [CI] 1.413-2.260; P<0.0001), pre-diabetes (12.1% . 6.1%; HR 2.069, 95%CI 1.518-2.821; P<0.0001) and NGR (11.8% . 6.1%; HR 2.009, 95%CI 1.473-2.740; P<0.0001). After the potential confounders were adjusted, high ABG was significantly associated with higher risk of 2-year mortality in patients with diabetes (adjusted HR 1.710, 95%CI 1.327-2.203; P<0.0001), pre-diabetes (adjusted HR 1.731, 95%CI 1.249-2.399; P=0.001) and NGR (adjusted HR 1.529, 95%CI 1.110-2.106; P=0.009). Moreover, adding ABG to the original model led to a slight albeit significant improvement in C-statistic and net reclassification in patients with diabetes and NGR (all P<0.05).
Conclusions: This study is the first to demonstrate a strong positive association between ABG and 2-year mortality in AMI patients with diabetes, pre-diabetes and NGR. ABG should be considered as a useful marker for risk stratification in patients with diabetes and NGR. Further randomized trials are warranted to investigate the effects of blood glucose control on the reduction of long-term mortality according to the corresponding ABG thresholds for different glucose metabolism status.
Clinical Trial Registration: ClinicalTrials.gov, identifier NCT01874691.
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http://dx.doi.org/10.3389/fendo.2022.898384 | DOI Listing |
J Infect Dev Ctries
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Chest Dpt., Ahmed Maher Teaching Hospital, GOTHI, Cairo, Egypt.
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J Infect Dev Ctries
December 2024
Nephrology Department, UHC Mother Tereza, Tirane, Albania.
Introduction: Acute kidney injury involves inflammation and intrinsic renal damage, and is a common complication of severe coronavirus disease 2019 (COVID-19). Baseline chronic kidney disease (CKD) confers an increased mortality risk. We determined the renal long-term outcomes of COVID-19 in patients with baseline CKD, and the risk factors prompting renal replacement therapy (RRT) initiation and mortality.
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January 2025
Department of Molecular Medicine, University of Southern Denmark; Odense, 5230, Denmark. Electronic address:
Neovascular age-related macular degeneration and diabetic macular edema are leading causes of vision-loss evoked by retinal neovascularization and vascular leakage. The glycoprotein microfibrillar-associated protein 4 (MFAP4) is an integrin αβ ligand present in the extracellular matrix. Single-cell transcriptomics reveal MFAP4 expression in cell-types in close proximity to vascular endothelial cells including choroidal vascular mural cells and retinal astrocytes and Müller cells.
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January 2025
Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
One hallmark of cancer is the upregulation and dependency on glucose metabolism to fuel macromolecule biosynthesis and rapid proliferation. Despite significant pre-clinical effort to exploit this pathway, additional mechanistic insights are necessary to prioritize the diversity of metabolic adaptations upon acute loss of glucose metabolism. Here, we investigated a potent small molecule inhibitor to Class I glucose transporters, KL-11743, using glycolytic leukemia cell lines and patient-based model systems.
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January 2025
Department of Surgery, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, USA.
Background: Classic congenital adrenal hyperplasia, primarily due to 21-hydroxylase deficiency, leads to impaired cortisol and aldosterone production and excess adrenal androgens. Lifelong glucocorticoid therapy is required, often necessitating supraphysiological doses in youth to manage androgen excess and growth acceleration. These patients experience higher obesity rates, hypertension, and glucose metabolism issues, complicating long-term health management.
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