Data are limited regarding the best prognostic glucose measure for patients admitted for an

acute coronary event. We examined the admission fasting glucose levels among patients

with acute coronary syndrome (ACS) from the University of Michigan ACS registry. The

The primary outcome measures included mortality and a composite end point (stroke,

recurrent infarction, and death) in hospital and at 6 months after the ACS event. Of the

1,525 patients (29% with diabetes) for whom glucose levels were available, a fasting glucose

the Global Registry of Acute Coronary Events risk score and gender. A fasting glucose level

adverse events (odds ratio 3.37, 95% confidence interval 1.51 to 7.51). The fasting glucose

level was associated with an increased risk of 6-month mortality among nondiabetics (odds

ratio 3.03, 95% confidence interval 1.35 to 6.81 for patients with a glucose level of 100 to

125 mg/dl; and odds ratio 2.81, 95% confidence interval 1.07 to 7.36 for patients with a

strong association between the admission fasting glucose level and mortality, particularly

among nondiabetic patients. Whether improving the diagnosis and treatment of hyperglycemia

would result in reductions in adverse events after ACS remains unclear. © 2009

Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104:470–474)