the predictive value of admission blood glucose level on the short term course and the extent of coronary artery occlusion in non-diabetic patients with acute myocardial infarction

in patients with acute myocardial infarction, stress hyperglycemia can commonly be observed. An association between hyperglycemia and increased risk of mortality and poor prognosis after AMI was well noted in patients with or without diabetes; poor outcomes of patients with AMI may be related to hyperglycemia.Objectives: The objective of this study is to evaluate the impact of blood glucose level on admission in non-diabetic patients presented with AMI on the occurrence of major cardiac complications and the extent of coronary artery occlusion by angiography in an attempt to assess the predictive value of admission blood glucose level on the outcome of the patient.Methods: A total of 100 patients presented without diabetes mellitus and having AMI were classified into 2 groups (50 patients each) according to their admission blood glucose level, Group A with stress hyperglycemia and Group B normoglycemic patients. Findings of the 30 days follow up (as regard to the occurrence of major cardiac complications) and of the coronary angiography were compared between the 2 groups.Results: Our results revealed that group A were older (p= 0.028), presented more with STEMI (p= 0.016), have higer values of CK total, CKMB and Troponin I (p= 0.000), have higher number of patients having 3-4 vessels affected by lesions (p= 0.01), have higher number of patients with more than 5 significant lesions (p= 0.03), have higher number of patients requiring CABG as a treatment (p= 0.04) and On the 30 day follow up have higher incidence of death (p= 0.03), heart failure (p=0.03), recurrent ischemia (p= 0.04), incidence of arrhythmias (p=0.01) and the incidence of cardiogenic shock (p=0.01).Conclusion: Our initial results suggest that stress hyperglycemia had a significant impact on the outcomes at 30 days follow up, the number of patients having 3-4 vessels affected, the number of patients having more than 5 significant lesions and the number of patients requiring CABG as a treatment in non-diabetic patients presented by acute myocardial infarction.Key words: Acute myocardial infarction (AMI) – Coronary artery bypass grafting (CABG) – S-T segment elevation myocardial infarction (STEMI).