PMID- 17199727
OWN - NLM
STAT- MEDLINE
DCOM- 20070417
LR  - 20221207
IS  - 1462-8902 (Print)
IS  - 1462-8902 (Linking)
VI  - 9
IP  - 1
DP  - 2007 Jan
TI  - Implications of hyperglycaemia and ethnicity in patients with acute coronary 
      syndromes in New Zealand.
PG  - 121-6
AB  - BACKGROUND: Admission blood glucose (ABG) is an independent predictor of death in 
      patients with acute ST elevation myocardial infarction (STEMI). In New Zealand, 
      mortality following myocardial infarction is disproportionally higher in Maori. 
      Little information, however, exists concerning the predictive value of ABG in 
      non-ST elevation acute coronary syndromes (NSTEACS) events or indeed if similar 
      ethnic differences exist in outcome in this patient population. AIM: To assess 
      the predictive value of ABG and ethnicity in individuals admitted with acute 
      coronary syndromes (ACS) on mortality. METHODS: A retrospective analysis of 
      hospital discharge diagnosis of all ACS between 1 January 1999 and 31 December 
      2002 at Waikato hospital, Hamilton, New Zealand. The primary outcome was 
      all-cause mortality. RESULTS: There were 4408 episodes of ACS with 1091 (25%) due 
      to STEMI. There were 806 (18%) deaths. The presence of diabetes mellitus (DM) or 
      an elevated ABG, in the absence of a history of DM, was associated with poor 
      patient outcome. Early mortality is seen in individuals presenting with STEMI. 
      People in the highest glucose category were older, more likely to be Maori, had a 
      higher percentage of people with diabetes and remained in hospital longer, 
      regardless of ACS type, than those in the lowest glucose category. Diabetes was 
      more common in Maori (33%) than in Europeans (17.5%); p < 0.001. Significant risk 
      factors for mortality were age, gender, diabetes, ethnicity, glucose and STEMI. 
      For each mmol/l increase in glucose there is a 4.3% increase risk of dying. 
      Adjusting for age and gender, Maori have a much higher mortality than Europeans 
      (RR 2.12; p < 0.00001) regardless of ACS type (STEMI or NSTEACS). CONCLUSIONS: 
      Our study confirms the higher mortality following ACS, of Maori compared to New 
      Zealanders of European origin. A raised ABG is a marker of this increased risk in 
      all patients with ACS.
FAU - Scott, A R
AU  - Scott AR
AD  - Department of Diabetes, Waikato Hospital, Hamilton, New Zealand. 
      adrian.scott@sth.nhs.uk
FAU - Cheng, A
AU  - Cheng A
FAU - Greenacre, M
AU  - Greenacre M
FAU - Devlin, G
AU  - Devlin G
LA  - eng
PT  - Journal Article
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Blood Glucose/analysis
MH  - Epidemiologic Methods
MH  - Female
MH  - Humans
MH  - Hyperglycemia/*complications/ethnology
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/*ethnology/mortality
MH  - Native Hawaiian or Other Pacific Islander/*statistics & numerical data
MH  - New Zealand/epidemiology
MH  - Prognosis
MH  - White People/statistics & numerical data
EDAT- 2007/01/04 09:00
MHDA- 2007/04/18 09:00
CRDT- 2007/01/04 09:00
PHST- 2007/01/04 09:00 [pubmed]
PHST- 2007/04/18 09:00 [medline]
PHST- 2007/01/04 09:00 [entrez]
AID - DOM597 [pii]
AID - 10.1111/j.1463-1326.2006.00597.x [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2007 Jan;9(1):121-6. doi: 10.1111/j.1463-1326.2006.00597.x.