Methods: Three hundred-one consecutive patients hospitalized for STEMI were enrolled. Patients were stratified into four groups based on their history of diabetes and the presence of AH (plasma glucose level> 11.0 mmol/l or 200 mg/dl). The pre-specified endpoint was the composite of all-cause mortality, non-fatal MI and stroke after one year follow up.

Results: The incidence of the endpoint was 19.6%(35 all-cause deaths, 21 non-fatal MIs, and 3 strokes). Non-diabetic patients with AH exhibited a significantly higher incidence of the composite endpoint compared to those with neither diabetes nor AH (50% vs. 15.3%, log rank p< 0.001) and diabetics with or without AH (50% vs. 17.2% vs. 19.3%, log rank p< 0.05 for both). Ejection fraction (HR 0.946, p= 0.007), treatment with primary percutaneous coronary intervention (HR= 0.488, p= 0.041), and AH in the absence of known diabetes (HR 2.207, p= 0.043) were the only independent predictors of the endpoint. Conclusions: AH in non-diabetic STEMI patients is accompanied by a worse long-term prognosis compared to diabetics (with or without AH) or normoglycemic patients and constitutes a potent predictor of an adverse outcome.