论文部分内容阅读
Aims: The study evaluated the associations between glycometabolic parameters at admission and during hospitatization and 2 year all-cause mortality risk in an unselected cohort of consecutive patients with diabetes admitted for unstable angina or non-Q-wave myocardial infarction to a university hospital during 1988-98. Methods and results: A total of 713 consecutive patients with diabetes were included. During 2 years of follow-up, 242(34% ) patients died. All analyses were retrospective using prospectively collected clinical data. The primary study endpoint was 2 year all-cause mortality collected from the Swedish cause-specific mortality register. In unadjusted analyses, high admission blood glucose(highest vs. lowest quartile: hazard ratio(HR) 2.66; 95% confidence interval(CI) 1.83, 3.86) and hypoglycaemia recorded during hospitalization(hypoglycaemia vs. normal: HR 1.77; 95% CI 1.09, 2.86) were both significantly associated with increased 2 year all-cause mortality risk. These associations remained significant after multivariable adjustment. Conclusion: In the setting of acute coronary syndromes(ACS) among patients with diabetes, hyperglycaemia on arrival and hypoglycaemia during hospitalization are both independently associated with worse adjusted all-cause 2 year mortality risk. These observations suggest that the avoidance of both hyper-and hypoglycaemia during ACS events may be of similar importance, and glucose modulation remains an important objective to address in future randomized trials.
Aims: The study evaluated the associations between glycometabolic parameters at admission and during hospitatization and 2 year all-cause mortality risk in an unselected cohort of consecutive patients with diabetes admitted for unstable angina or non-Q-wave myocardial infarction to a university hospital during 1988 The primary study endpoint was 2 -98. Methods and results: A total of 713 consecutive patients with diabetes were included. During 2 years of follow-up, 242 (34%) patients died. All analyzes were retrospective using prospectively collected clinical data. year all-cause mortality collected from the Swedish cause-specific mortality register. In unadjusted analyzes, high admission blood glucose (highest vs. lowest quartile: hazard ratio (HR) 2.66; 95% confidence interval (CI) 1.83, 3.86) and hypoglycaemia recorded during hospitalization (hypoglycaemia vs. normal: HR 1.77; 95% CI 1.09, 2.86) were both significantly associated with increased 2 year all-cause mortality risk. These asso Conclusion: In the setting of acute coronary syndromes (ACS) among patients with diabetes, hyperglycaemia on arrival and hypoglycaemia during hospitalization are both associated associated with worse adjusted all-cause 2 year mortality risk. These observations suggest that the avoidance of both hyper-and hypoglycaemia during ACS events may be of similar importance, and glucose modulation remains an important objective to address in future randomized trials.