Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .
Admission glucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention.
BACKGROUND In patients with acute myocardial infa rct ion ( MI ) , increased plasma glucose levels at hospital admission are associated with worse outcome . We aim ed to assess the predictive value of admission glucose concentrations on short- and long-term mortality in patients with acute MI undergoing primary or rescue percutaneous coronary intervention ( PCI ) .  METHODS We analyzed the 30-day and long-term ( mean follow-up 3.7 years ) outcome of 978 patients prospect ively included in a single-center registry of patients with acute MI treated with PCI within 24 hours after onset of symptoms . Patients were classified according to plasma glucose levels at admission : < 7.8 mmol/L ( group I , n = 322 ) , 7.8 to 11 mmol/L ( group II , n = 348 ) , and > 11.0 mmol/L ( group III , n = 308 ) . RESULTS Mortality at 30 days was 1.2 % in group I , 6.3 % in group II , and 16.6 % in group III ( P < .001 ) . After multivariate adjustment for age , the presence of cardiogenic shock , and TIMI 3 flow after PCI , the association of mortality with glucose classification remained significant ( P value for trend = .003 ) . The relative risk of death at 30 days for group III versus group I was 3.9 ( 95 % CI 1.2 - 13.2 ) . During long-term follow-up , mortality was similar in groups I and II . However , in group III adjusted mortality remained significantly increased compared with group I ( relative risk 1.76 , CI 1.01 - 3.08 ) . CONCLUSIONS In patients undergoing emergency PCI for acute MI , glucose levels at hospital admission are predictive for short- and long-term survival . Knowledge of admission glucose levels may improve initial bedside risk stratification
Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .