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

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• 作者：Patrí ; cia Tolledo Maciel ; Lucia Campos Pell ; a ; Vera Lucia Portal ; Beatriz D’ ; Agord Schaan
• 关键词：Acute coronary syndromes ; Glycemia ; Inflammatory markers ; Major cardiovascular events ; Mortality
• 刊名：Diabetes Research and Clinical Practice
• 出版年：2007
• 期刊代码：78_01688227
• 类别：med
• 出版时间：November 2007
• 卷：78
• 期：2
• 页码：263-269
• 文件大小：224 K

摘要

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 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 (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.