TY - JOUR
T1 - Association Between Blood Glucose and Long-Term Mortality in Patients With Acute Coronary Syndromes in the OPUS-TIMI 16 Trial
AU - Bhadriraju, Satish
AU - Ray, Kausik K.
AU - DeFranco, Anthony C.
AU - Barber, Kim
AU - Bhadriraju, Padmini
AU - Murphy, Sabina A.
AU - Morrow, David A.
AU - McCabe, Carolyn H.
AU - Gibson, C. Michael
AU - Cannon, Christopher P.
AU - Braunwald, Eugene
N1 - Funding Information:
OPUS-TIMI 16 was funded by Searle, Chicago, Illinois, and TACTICS-TIMI 18 was funded by Merck, Inc., West Point, Pennsylvania.
PY - 2006/6/1
Y1 - 2006/6/1
N2 - Hyperglycemia in the context of acute coronary syndrome (ACS) is a common observation, and existing data suggest that high glucose levels are associated with increased in-hospital mortality. We assessed the relation between random glucose and long-term mortality in 9,020 patients with ACS who were enrolled in the OPUS-TIMI 16 trial. A significant relation between glucose level and 10-month mortality was observed (2.7% in quartile 1 vs 7.0% in quartile 4, p <0.0001). After multivariable adjustment for co-morbidity, which included history of diabetes, this relation remained significant (quartile 4 vs 1, hazard ratio 1.70, 95% confidence interval 1.16 to 2.50, p = 0.006). These observations were similar in the TACTICS-TIMI 18 trial. In addition, we observed that B-type natriuretic peptide and troponin I levels increased across glucose quartiles in the OPUS-TIMI 16 trial (p values for trend = 0.002 and 0.0001, respectively) and the TACTICS-TIMI 18 trial (p values for trend = 0.006 and 0.0001, respectively). High blood glucose during ACS is an independent predictor of long-term mortality and is significantly correlated with prognostic biomarkers. Glucose levels during ACS may be an important addition to the risk stratification of patients with ACS and a potentially important target for therapy.
AB - Hyperglycemia in the context of acute coronary syndrome (ACS) is a common observation, and existing data suggest that high glucose levels are associated with increased in-hospital mortality. We assessed the relation between random glucose and long-term mortality in 9,020 patients with ACS who were enrolled in the OPUS-TIMI 16 trial. A significant relation between glucose level and 10-month mortality was observed (2.7% in quartile 1 vs 7.0% in quartile 4, p <0.0001). After multivariable adjustment for co-morbidity, which included history of diabetes, this relation remained significant (quartile 4 vs 1, hazard ratio 1.70, 95% confidence interval 1.16 to 2.50, p = 0.006). These observations were similar in the TACTICS-TIMI 18 trial. In addition, we observed that B-type natriuretic peptide and troponin I levels increased across glucose quartiles in the OPUS-TIMI 16 trial (p values for trend = 0.002 and 0.0001, respectively) and the TACTICS-TIMI 18 trial (p values for trend = 0.006 and 0.0001, respectively). High blood glucose during ACS is an independent predictor of long-term mortality and is significantly correlated with prognostic biomarkers. Glucose levels during ACS may be an important addition to the risk stratification of patients with ACS and a potentially important target for therapy.
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U2 - 10.1016/j.amjcard.2005.12.046
DO - 10.1016/j.amjcard.2005.12.046
M3 - Article
C2 - 16728216
AN - SCOPUS:33646694589
SN - 0002-9149
VL - 97
SP - 1573
EP - 1577
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -