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Abstract：
BACKGROUND: stress hyperglicemia (SH) is common in patients with ST-elevation myocardial infraction (STEMI). The aims of this study were to analyze the impact of SH on the incidence of all-cause mortality and major adverse cardiovascular events (MACE-cardiovascular death, nonfatal reinfarction, target vessel revascularization, and stroke) in STEMI patients without diabetes mellitus (DM) who have been treated successfully with primary PCI (pPCI).
METHODS: we analyzed 2362 STEMI patients treated with successful pPCI (post-procedural flow TIMI = 3) and without DM and cardiogenic shock at admission. Stress hyperglycemia was defined as plasma glucose level above 7.8 mmol/L at admission. The follow-up period was 8 years.
RESULTS: incidence of SH was 26.9%. Eight-year all-cause mortality and MACE rates were significantly higher in patients with SH, as compared to patients without SH (9.7% vs. 4.2%, p < 0.001, and 15.7% vs. 9.4%, p < 0.001). SH was an independent predictor of short- and long-term all-cause mortality (HR 2.19, 95%CI 1.16-4.18, and HR 1.99, 95%CI 1.03-3.85) and MACE (HR 1.49, 95%CI 1.03-2.03, and HR 1.35, 95%CI 1.03-1.89).
CONCLUSIONS: despite successful revascularization, SH at admission was an independent predictor of short-term and long-term (up to eight years) all-cause mortality and MACE, but its negative prognostic impact was stronger in short-term follow-up.
METHODS: we analyzed 2362 STEMI patients treated with successful pPCI (post-procedural flow TIMI = 3) and without DM and cardiogenic shock at admission. Stress hyperglycemia was defined as plasma glucose level above 7.8 mmol/L at admission. The follow-up period was 8 years.
RESULTS: incidence of SH was 26.9%. Eight-year all-cause mortality and MACE rates were significantly higher in patients with SH, as compared to patients without SH (9.7% vs. 4.2%, p < 0.001, and 15.7% vs. 9.4%, p < 0.001). SH was an independent predictor of short- and long-term all-cause mortality (HR 2.19, 95%CI 1.16-4.18, and HR 1.99, 95%CI 1.03-3.85) and MACE (HR 1.49, 95%CI 1.03-2.03, and HR 1.35, 95%CI 1.03-1.89).
CONCLUSIONS: despite successful revascularization, SH at admission was an independent predictor of short-term and long-term (up to eight years) all-cause mortality and MACE, but its negative prognostic impact was stronger in short-term follow-up.
摘要：
背景：应激性高血糖（SH）在ST段抬高型心肌梗死（STEMI）患者中很常见。这项研究的目的是分析SH对全因死亡率和主要不良心血管事件（MACE-心血管死亡，非致命性再梗死,靶血管血运重建,和卒中）在无糖尿病（DM）的STEMI患者中成功接受了直接PCI（pPCI）治疗。
方法：我们分析了2362例成功接受pPCI（术后流程TIMI=3）且入院时无DM和心源性休克的STEMI患者。应激性高血糖定义为入院时血浆葡萄糖水平高于7.8mmol/L。随访期为8年。
结果：SH的发生率为26.9%。SH患者的八年全因死亡率和MACE发生率明显更高，与没有SH的患者相比(9.7%与4.2%，p<0.001，15.7%与9.4%,p<0.001)。SH是短期和长期全因死亡率（HR2.19,95CI1.16-4.18和HR1.99,95CI1.03-3.85）和MACE（HR1.49,95CI1.03-2.03和HR1.35,95CI1.03-1.89）的独立预测因子。
结论：尽管成功的血运重建，入院时SH是短期和长期（长达8年）全因死亡率和MACE的独立预测因子，但在短期随访中,其负面预后影响更强.
方法：我们分析了2362例成功接受pPCI（术后流程TIMI=3）且入院时无DM和心源性休克的STEMI患者。应激性高血糖定义为入院时血浆葡萄糖水平高于7.8mmol/L。随访期为8年。
结果：SH的发生率为26.9%。SH患者的八年全因死亡率和MACE发生率明显更高，与没有SH的患者相比(9.7%与4.2%，p<0.001，15.7%与9.4%,p<0.001)。SH是短期和长期全因死亡率（HR2.19,95CI1.16-4.18和HR1.99,95CI1.03-3.85）和MACE（HR1.49,95CI1.03-2.03和HR1.35,95CI1.03-1.89）的独立预测因子。
结论：尽管成功的血运重建，入院时SH是短期和长期（长达8年）全因死亡率和MACE的独立预测因子，但在短期随访中,其负面预后影响更强.
