2004 25(4):308-312; doi:10.1016/j.ehj.2003.12.014
Copyright © 2004 by the European Society of Cardiology.
Clinical research
Impaired fasting glucose and cardiogenic shock in patients with acute myocardial infarction
a Service de Cardiologie, CHU Bocage, Dijon, France
b Service d'Endocrinologie, CHU Bocage, Dijon, France
c Service de Cardiologie, Clinique de Fontaine, Fontaine les Dijon, France
d Service de Cardiologie, Centre Hospitalier, Semur en Auxois, France
e Service de Cardiologie, Centre Hospitalier, Beaune, France
f Service de Cardiologie, Centre Hospitalier, Châtillon sur Seine, France
Received November 21, 2003;
revised December 19, 2003;
accepted December 22, 2003
* Correspondence author. Tel: +33 3802933.11; Fax: +33 80293333
E-mail address: marianne.zeller{at}u-bourgogne.fr
Objectives In-hospital outcome after acute myocardial infarction (MI) has not yet been evaluated with regard to the new category of Impaired Fasting Glucose level (IFG) patients defined by the American Diabetes Association (ADA).
Methods Nine hundred and ninety-nine patients with acute MI from the RICO survey were included in the study. Fasting blood glucose was measured after admission. Patients were grouped according to ADA definitions: Diabetes Mellitus (DM) (FG 
7mmol/l or personal history of DM); IFG (FG 6.1 to 7mmol/l); NFG (normal FG <6.1mmol/l).
Results Three hundred and eighty-one patients (38%) had DM, 145 (15%) IFG and 473 (47%) NFG. Mortality in the IFG group was twice that of the NFG group (8% vs 4%, P=0.049). A significant increase in cardiogenic shock (12% vs 6%, P=0.011) and ventricular arrhythmia (15% vs 9%, P=0.035) was observed in the IFG vs NFG group. IFG, after adjustment for confounding factors (age, sex, anterior location, and LVEF), was a strong independent predictive factor for cardiogenic shock (P=0.005).
Conclusion MI patients with IFG had an overall worse outcome, characterized by a higher risk of developing cardiogenic shock during their hospital stay.
Key Words: Myocardial infarction • Cardiogenic shock • Diabetes mellitus • Glucose
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