급성 심근경색증 환자의 예후인자로서 내원 시 혈당의 유용성

Title
급성 심근경색증 환자의 예후인자로서 내원 시 혈당의 유용성
Other Titles
Admission Glucose Is a Useful Prognostic Factor in Patients with Acute Myocardial Infarction
Author(s)
김영조김은정[김은정]박오장[박오장]정명호[정명호]안영근[안영근]김주한[김주한]채성철[채성철]홍택종[홍택종]성인환[성인환]채제건[채제건]김종진[김종진]조명찬[조명찬]승기배[승기배]박승정[박승정]
Keywords
심근경색증; 고혈당; 예후; Myocardial infarction; Hyperglycemia; Prognosis
Issue Date
201005
Publisher
대한내과학회
Citation
대한내과학회지, v.79, no.1, pp.23 - 31
Abstract
Background/Aims: It has been suggested that admission hyperglycemia is associated with poor clinical outcomes in patients with acute myocardial infarction (AMI). The aim of this study was to assess the relationship between admission hyperglycemia and short-long term prognosis in patients with AMI. Methods: A total of 6,030 AMI patients without a previous history of diabetes were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into three groups according to the levels of admission glucose levels: group I (<140 mg/dL, n=3,307), group II (140~199 mg/dL, n=1,946), and group III (≥200 mg/dL, n=777). In-hospital and one-year mortality were compared among three the groups.∙Received: 2009. 12. 3∙Accepted: 2010. 5. 11∙Correspondence to Myung Ho Jeong, M.D., Ph.D., Director of the Heart Research Center Designated by Korea Ministry of Health and Welfare, Chonnam National University Hospital, 671 Jaebon-ro, Dong-gu, Gwangju 501-757, Korea E-mail: myungho@chollian.net Results: The mean age was 64.3±13.3, 65.9±12.7, and 67.7±13.0 years in group I, II and III, respectively. The proportion of female gender (23.9%, 29.5%, 35.0%; p<0.001), Killip class III-IV (8.9%, 12.3%, 28.3%; p<0.001), ST-segment elevation myocardial infarction (54.6%, 71.5%, 71.7%; p<0.001), and in-hospital mortality (3.5%, 7.5%, 19.7%; p<0.001) increased with higher tertiles of elevated values of initial serum glucose. Hazard ratio (HR) for mortality rate were significantly increased in group II [HR=1.19, 95% confidential interval (Cl) 1.02~1.40, p=0.032], and in group III [HR=1.91, 95% Cl 1.59~2.30, p=0.001], compared with group I. And also significant differences were existed between group II and group III [HR =1.55, 95% Cl 1.27~1.88, p=0.001]. Conclusions: Admission glucose in patients with AMI provides incremental prognostic value, and significantly correlates with in-hospital and one-year mortalities.
URI
http://hdl.handle.net/YU.REPOSITORY/22413
ISSN
1226-329X
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의과대학 > 내과학교실 > Articles
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