Diferentes valores de glucemia al ingreso y en ayunas predicen mortalidad en el infarto agudo de miocardio: Registro Argentino de Infarto Agudo SAC-FAC

Introduction: Hyperglycemia is associated with adverse evolution in ST-elevation myocardial infarction (STEMI). Objectives: To evaluate the prognostic value of blood sugar level at admission and fasting to identify the in-hospital risk of STEMI. Material and methods: The ARGEN-IAM-ST was a prospective, observational registry, conducted on 247 Argentine centers, including patients with STEMI, between March and December/2015. From the total, 1254 cases were included in this analysis with determinations of glycemia on admission and fasting. Results: The average age of the population was 66.2±13.4 years, 22% were women. Eighty-sixpercent received reperfusion strategy. Overall in-hospital mortality in the Registry was 8.8%. The area under the ROC curve for mortality prediction for glycemia at admission (GluAd) and fasting (GluFas) was 0.66 and 0.67, and the population was divided by the lowest value (1) or greater (2) of the median of 136 and 110 mg/dl, respectively. The mortality related to these cutoff points with respect to GlyAd-1 vs GlyAd-2 was 3.7 vs 11.3% (p 136 mg/dl (OR: 2.148, 95% CI 1.051-4.388, p=0.01); age (OR 1.073, 95% CI 1.044-1.102, p=0.002) and heart failure (OR 20, 95% CI 7.700-51.985, p 136 mg/dl) and fasting (>110 mg/dl). However, blood glucose determination at STEMI admission represents the best high-risk metabolic indicator.