Friday, May 5, 2017

Q: Which of the following can have a predictive value in acute myocardial infarction (AMI)?

A) Glucose 
B) Sodium
C) Potassium
D) Calcium
E) Creatinine

Answer: A

In patients who don't have diabetes, and  have glucose concentrations between 110 and 143 mg/dL at presentation with AMI have a 3.9-fold higher risk of death in comparison to patients with lower glucose concentrations. Moreover, glucose values between 144 and 180 mg/dL  have a three-fold higher risk of  some degree of cardiogenic shock.

Diabetic patients with glucose concentrations more or equal to 180 to 196 mg/dL  have a higher risk of death compared with diabetic patients having normal or lower glucose level.


1. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000; 355:773. 

2. Malmberg K, Norhammar A, Wedel H, Rydén L. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study. Circulation 1999; 99:2626. 

3. Goyal A, Mehta SR, Díaz R, et al. Differential clinical outcomes associated with hypoglycemia and hyperglycemia in acute myocardial infarction. Circulation 2009; 120:2429.

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