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The magnitude of the variation in glycemia: a new parameter for risk assessment in acute coronary syndrome?

dc.contributor.authorMonteiro, S
dc.contributor.authorGonçalves, F
dc.contributor.authorMonteiro, P
dc.contributor.authorFreitas, M
dc.contributor.authorProvidência, LA
dc.date.accessioned2009-11-24T13:09:32Z
dc.date.available2009-11-24T13:09:32Z
dc.date.issued2009
dc.description.abstractINTRODUCTION AND OBJECTIVES: The aim was to evaluate the relationship between the magnitude of the variation in the level of glycemia during hospitalization and in-hospital and long-term mortality and postdischarge endpoints in two groups of patients with acute coronary syndrome: those with and those without a previous diagnosis of diabetes. METHODS: The study included 1210 patients admitted for acute coronary syndrome between May 2004 and July 2007. The study population was divided in two subgroups: patients with a previous diagnosis of diabetes (n=386) and nondiabetics (n=824). Each subgroup was further divided into four smaller groups according to the quartile of glycemia variation: diabetics (Q1: <46 mg/dl; Q2: 46-88 mg/dl; Q3: 88-164 mg/dl; Q4: >or=164 mg/dl) and nondiabetics (Q1: <14 mg/dl; Q2: 14-30 mg/dl; Q3: 30-60 mg/dl; Q4: >or=60 mg/dl). Patients were followed up for an average of 18 months after the occurrence of the acute coronary syndrome. RESULTS: In diabetic patients, there was no relationship between the magnitude of the glycemia variation and in-hospital or postdischarge endpoints. In nondiabetics, no significant difference was observed in in-hospital mortality or morbidity, but statistically significant clinical differences were found during follow-up. Multivariate regression analysis showed that Q4 versus Q1, age >or=70 years, and previous antiplatelet or angiotensin-converting enzyme inhibitor therapy were independent predictors of postdischarge endpoints in the nondiabetic group. CONCLUSIONS: In nondiabetic acute coronary syndrome patients, the magnitude of the variation in glycemia observed during hospitalization was a strong independent predictor of postdischarge clinical endpoints.pt
dc.identifier.citationRev Esp Cardiol. 2009 Oct;62(10):1099-108.pt
dc.identifier.urihttp://hdl.handle.net/10400.4/703
dc.language.isoengpt
dc.subjectAvaliação de Riscopt
dc.subjectSíndrome Coronária Agudapt
dc.subjectGlicémiapt
dc.titleThe magnitude of the variation in glycemia: a new parameter for risk assessment in acute coronary syndrome?pt
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspt
rcaap.typearticlept

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