Original article
Glucose metabolism abnormalities after acute myocardial infarction in patients with one-vessel coronary artery disease, treated with primary percutaneous coronary intervention – 1-year follow-up

Introduction: Myocardial infarction (MI) is the leading cause of death in patients with diabetes mellitus (DM). Diabetes mellitus remains a significant factor which worsens prognosis after primary angioplasty and is an independent risk factor of reocclusion. Aim: 1. To assess frequency of impaired glucose tolerance (IGT) in acute myocardial infarction and its 1-year follow-up progression in patients with one-vessel coronary artery disease. 2. Evaluation of laboratory parameters indicating IGT in prognosis of cardio-vascular events and incidence of main adverse events and cardiovascular hospitalisations.
Material and methods: The study group consisted of 83 consecutive patients admitted to our institution due to acute MI with one- vessel coronary artery disease, in whom primary PCI (percutaneous coronary intervention) with bare metal stent implantation was performed. We analysed IGT and long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTTs). The classification was performed before hospital discharge and 12 months later.
Results: The prevalence of abnormal glucose metabolism among patients suffering from acute MI was 73.5%. Previously undetected glucose abnormalities were diagnosed in 46 patients (56.6%). All cardiovascular events were in pts with IGT. Seventy cardiovascular events (89.5%) were in patients with DM. High glucose level and HbA1c were observed in the group of patients with increased cardiovascular adverse events. Lower level of glucose and HbA1c on admission were observed in patients without disturbances of glucose metabolism.
Conclusions: Previously undetected glucose metabolism abnormalities are common in patients with acute myocardial infarction (2/3 of patients). Twenty percentage of patients with AMI have DM. The outcome of an OGTT performed in AMI patients at hospital discharge reliably predicts long-term glucometabolic state. Glucose level at admission, at hospital discharge and on the 6th day of hospitalisation seem to be good predictors of cardiovascular adverse events during one-year follow-up.