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Abstract

Background

Ventricular dysfunction in acute coronary syndrome (ACS) patients is a recognized predictor of in-hospital and post-discharge morbidity and mortality. Recently, hyperglycemia at admission has been considered as an important marker of poor in-hospital prognosis.

Aim

To characterize an ACS population and to identify independent predictors of one-year mortality.

Methods

This study included 1179 consecutive patients admitted to a single coronary care unit for acute coronary syndrome between May 2004 and December 2006. Patients were followed up for 12 months after ACS.

Results

In our population, 70.9% of patients were male, with a mean age of 66.6 ± 12.5 years; 15.7% were admitted by unstable angina, 44.7% by non-ST elevation myocardial infarction and 38.5% by ST elevation myocardial infarction; 16% of patients had left ventricular systolic dysfunction during the index admission. In-hospital mortality was 3.5% and complications occurred in 5.6% of patients. Mortality rate at 1-year of follow-up was 8.8% and rehospitalization rate for heart failure was 5.5%. After multivariate regression analysis, left ventricular systolic dysfunction [odds ratio (OR): 3.58; confidence interval (CI): 1.57-8.16], glycemia at admission >137 mg/dl (OR: 3.58; CI: 1.52-8.47) and age >65 years (OR: 2.67; CI: 1.08-6.59) were independent predictors of 1-year mortality.

Conclusion

In this population, hyperglycemia at admission was an independent predictor of 1-year mortality, with a predictive value equivalent to that of left ventricular systolic dysfunction. This fact, never before described, emphasizes the importance of metabolic abnormalities and their control in the prognosis of ACS patients. Eur J Cardiovasc Prev Rehabil 16:164-168 © 2009 The European Society of Cardiology

acute coronary syndrome, admission glycemia, metabolic control, prognosis, stress hyperglycemia, ventricular dysfunction
© The European Society of Cardiology 2009
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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