• Medicina intensiva · Mar 2014

    Markers for early detection of alterations in carbohydrate metabolism after acute myocardial infarction.

    • J H de Gea-García, L Benali, J Galcerá-Tomás, A Padilla-Serrano, E Andreu-Soler, A Melgarejo-Moreno, and N Alonso-Fernández.
    • Unidad de Cuidados Intensivos, Hospital Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: josehdegea@hotmail.com.
    • Med Intensiva. 2014 Mar 1;38(2):83-91.

    ObjectivesUndiagnosed abnormal glucose metabolism is often seen in patients admitted with acute myocardial infarction, although there is no consensus on which patients should be studied with a view to establishing an early diagnosis. The present study examines the potential of certain variables obtained upon admission to diagnose abnormal glucose metabolism.DesignA prospective cohort study was carried out.SettingThe Intensive Care Unit of Arrixaca University Hospital (Murcia), Spain.PatientsA total of 138 patients admitted to the Intensive Care Unit with acute myocardial infarction and without known or de novo diabetes mellitus. After one year, oral glucose tolerance testing was performed.Main OutcomesClinical and laboratory test parameters were recorded upon admission and one year after discharge. Additionally, after one year, oral glucose tolerance tests were made, and a study was made of the capacity of the variables obtained at admission to diagnose diabetes, based on the ROC curves and multivariate analysis.ResultsOf the 138 patients, 112 (72.5%) had glucose metabolic alteration, including 16.7% with diabetes. HbA1c was independently associated with a diagnosis of diabetes (RR: 7.28, 95%CI 1.65 to 32.05, P = .009), and showed the largest area under the ROC curve for diabetes (0.81, 95%CI 0.69 to 0.92, P = .001).ConclusionsIn patients with acute myocardial infarction, HbA1c helps identify those individuals with abnormal glucose metabolism after one year. Thus, its determination in this group of patients could be used to identify those subjects requiring a more exhaustive study in order to establish an early diagnosis.Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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