Background: Elevated admission plasma glucose (APG) levels >140mg/dl are associated with adverse clinical outcomes in both diabetic and non-diabetic patients admitted with acute coronary syndromes (ACS). We aimed to evaluate the association between APG levels<140mg/dl and all-cause mortality at 1 year in non-diabetic patients admitted with ACS.
Methods: The study population consisted of patients with ACS included in the Acute Coronary Syndromes Israeli biennial Surveys (ACSIS) during 2000-2013. Patients with a history of diabetes mellitus were excluded. The primary endpoint was all-cause mortality at 1 year.
Results: The 4,524 patients had a mean age of 61.7±13.5 years and were stratified into 4 quartiles according to APG (60-94, 95-105, 106-119, 120-140mg/dl). Patients with higher APG were older and included a higher percentage of smokers. In addition, the higher the glucose so also did they have a poorer risk factor profile including a higher BMI, total and LDL-cholesterol and triglyceride levels, and lower HDL-cholesterol levels. During the first year 5.2% of patients died. A comparison of 1-year mortality according to APG quartiles demonstrated a significant and progressive increase in mortality risk as APG rose (3.5%, 4.1%, 6.1%, 6.4%, p=0.001).
Conclusions: High APG levels even within the normal to mildly impaired range, are associated with increased 1-year all-cause mortality in non-diabetic patients admitted with ACS. Further investigation is needed for better understanding of this association before therapeutic recommendations can be made.
