A recent study published in the Journal of Diabetes and its Complications investigated if abnormal
glucose tolerance (AGT) affects post-myocardial infarction (MI) prognosis in patients with
hospital-related hyperglycaemia (HRH) but without known diabetes mellitus (KDM).
In this study the post-MI survivors without KDM were subjected to a pre-discharge oral glucose tolerance
test. Cardiovascular death and non-fatal re-infarction (MACE) were recorded. The ability of admission
(APG), fasting (FPG) and 2 h post-load (2 h-PG) plasma glucose are compared to predict MACE in patients
with HRH and without HRH (NoHRH).
The results were such that 50.2% and 73% of NoHRH and HRH had AGT respectively and MACE occurred in 19.5%
and 18.1% in HRH and NoHRH groups. MACE-free survival was lower in patient with AGT in both groups (NoHRH:
HR 1.82, 95% CI 1.19–2.78, p = 0.005; HRH: HR 2.48, 95% CI 1.24–4.96, p = 0.010). AGT predicted MACE-free
survival (NoHRH: HR 1.60, 95% CI 1.02–2.51, p = 0.042; HRH: HR 3.09, 95% CI 1.07–8.94, p = 0.037). 2 h-PG.
But not FPG or APG, independently predicted MACE free survival (NoHRH: HR 1.17, 95% CI 1.07–1.27, p ≤0.001
and HRH: HR 1.18, 95% CI 1.03–1.37, p = 0.020).
With these findings the study concluded that Post-MI prognosis is worse with Abnormal Glucose Tolerence
irrespective of presence of Hospital-Related Hypoglycemia. In addition 2 h-PG, predicts prognosis in
Hospital-Related Hypoglycemia and without Hospital-Related Hypoglycemia groups.