Blood glucose levels in acute coronary syndrome are an indicator of risk stratification

Blood glucose levels in acute coronary syndrome are an indicator of risk stratification of patients.

According to a study from the United States, "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."

S. Bhadriraju and colleagues, Brigham & Women's Hospital found "A significant relation between glucose level and 10-month mortality was observed (2.7% in quartile I vs 7.0% in quartile 4, p< 0.0001). After multivariable adjustment for comorbidity, 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," they continued, "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 longterm mortality and is significantly correlated with prognostic biomarkers."

The researchers concluded, "Glucose levels during ACS may be an important addition to the risk stratification of patients with ACS and a potentially important target for therapy."

Bhadriraju and colleagues published their study in American Journal of Cardiology (Association between blood glucose and long-term mortality in patients with acute coronary syndromes in the OPUS-TIMI 16 trial. Am J Cardiol, 2006;97(11):1573-1577).

For more information, contact C.P. Cannon, Brigham & Women's Hospital, TIMI Study Group, Division Cardiovascular, 75 Francis St., Boston, MA 02115, USA.

Publisher contact information for the American Journal of Cardiology is: Excerpta Medica Inc., 650 Avenue of the Americas, New York, NY 10011, USA.