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Colegio de Medicina Interna de México.

2007, Number 6

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Med Int Mex 2007; 23 (6)

Hyperglycemia during the acute phase of myocardial infract and its effect over left ventricle ejection fraction

López HMA, López VCE, Gómez VMA

Language: Spanish
References: 12
Page: 493-497
PDF size: 124.30 Kb.


ABSTRACT

Background: The hyperglycemia has shown to be a powerful predictor of bad prognosis during the acute infarct of myocardium with elevation of ST segment as well as the response to the treatment with thrombolytic agents. It has demonstrated to the significant relation of hyperglycemia like a prognosis of long term mortality marker and its correlation with prognostic biomarkers.
Objective: To evaluate the correlation of the serum glucose levels in patients with acute myocardial infarction with ST elevation treated with thrombolytic agents with the ejection fraction of the left ventricle.
Patients and methods: Design of the study: retrospective and observational. An analysis of all the patients with acute myocardial infarction with ST elevation was made, who received thrombolytic treatment from January 1st, 2004, to June 30th, 2006. Three groups were formednon diabetic patients with previous diagnosis of diabetes mellitus type 2 (group A, n = 11), patients with hyperglycemia (group B, n = 15), and patients without hyperglycemia (group C n = 15). An analysis of variances with Student’s t test with an alpha error = 0.050 and to be power of 0.95 was made.
Results: As far as the ejection fraction of the left ventricle in group A was 53 ± 6% (p = 0.0.5), in group B was 53 ± 9.97% (p = 0.5), and in group C was 53.85 ± 5.6% (p = 0.5). Average glucose level in the group A was 214.78 ± 80.08 mg/dL, in group B was 156.60 ± 31.55 mg/dL, and in group C was 98.78 ± 9.82 mg/dL.
Conclusions: There was no significant difference in the fraction of expulsion of the left ventricle in the three groups.


REFERENCES

  1. Van der Horst IC, Nijsten MW, Vogelzang M, Zijlstra F. Persistent hyperglycemia is an independent predictor of outcome in acute myocardial infarction. Cardiovasc Diabetol 2007;6:2.

  2. Macin SM, Perna ER, Coronel ML, Kriskovich JO, et al. Influence of admission glucose level on long-term prognosis in patients with acute coronary syndrome. Rev Esp Cardiol 2006;59(12):1268-75.

  3. Dirkali A, Van der Ploeg T, Nangrahary M, Cornel JH, Umans VA. The impact of admission plasma glucose on long-term mortality after STEMI and NSTEMI myocardial infarction. Int J Cardiol 2006 (Dec. 5).

  4. Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, et al. Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? JACC 2002;40(10):1748-54.

  5. Foo K, Cooper J, Deaner A, Knight C, et al. A single serum glucose measurement predicts adverse outcomes across the whole range of acute coronary syndromes. Heart 2003;89:512-516.

  6. Khoury VK, Haluska B, Prins J, Marwick TH. Effects of glucoseinsulin- potassium infusion on chronic ischaemic left ventricular dysfunction. Heart 2003;89:61-65.

  7. Rodríguez J, Melgarejo I, Roa C, Isaza D. Valoración de la función ventricular izquierda con ecocardiografía bi-dimensional en el infarto agudo del miocardio pre y posterapia trombolítica. Rev Colomb Cardiol 1988;2(6):439-42.

  8. Iwakura K, Ito H, Ikushima M, Kawano S, et al. Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction. JACC 2003;41(1):1-7.

  9. Devos P, Chiolero R, Van den Berghe G; Preiser JC. Glucose, insulin and myocardial ischaemia. Current Opinion in Clinical Nutrition & Metabolic Care 2006; 9(2):131-9.

  10. Zeller M, Verger B, L’Huillier I, Brun JM, Cottin Y. Glycemia in acute coronary syndromes. Diabetes Metab 2006;32(Spec. No.2):2S42-7.

  11. Bauters C, Ennezat PV, Tricot O, Lauwerier B, et al. Stress hyperglycaemia is an independent predictor of left ventricular remodelling after first anterior myocardial infarction in nondiabetic patients. Eur Heart J 2007;28(5):546-52.

  12. Lavi S, Kapeliovich M, Gruberg L, Roquin A, et al. Hyperglycemia during acute myocardial infarction in patients who are treated by primary percutaneous coronary intervention: impact on long-term prognosis. Int J Cardiol 2007 (Mar. 15): 23-33.




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