Document Detail


Current management of hyperglycemia in acute coronary syndromes: a national Dutch survey.
MedLine Citation:
PMID:  19491572     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hyperglycemia is common among patients admitted with acute coronary syndromes (ACS) and is associated with less favorable clinical outcomes. Guidelines for the treatment of hyperglycemia in myocardial infarction are confusing, partly because of lack of sufficient evidence. Neither do we know what the everyday practice on hyperglycemia in ACS is. Therefore the aim of our study is to describe current glucose management in ACS patients in The Netherlands. We designed a multiple-choice questionnaire that was emailed to all 94 independent cardiology departments of each of the 114 hospitals within The Netherlands. We interviewed cardiologists about their specific hospital setting, the presence, content, and actual use of a dedicated hyperglycemia protocol in the setting of ACS. Ninety-four questionnaires were returned (response rate 100%). Only 32% of the respondents reported to have a routinely applied, dedicated hyperglycemia protocol in the setting of ACS. An admission glucose of 13.0 mmol/L is considered a stress value by 60% of respondents. Treatment of hyperglycemia is postponed until after the acute phase (ie, after >6 hours) in 41% of the cardiology departments and in 76% HbA1c is not routinely measured before discharge. Only a minority of Dutch cardiology departments have a routinely applied, dedicated hyperglycemia protocol for patients admitted with ACS. Different views exist on the interpretation of admission hyperglycemia in patients without previously diagnosed diabetes. Dedicated protocols with well-established treatment goals allow early treatment and are mandatory to improve timely metabolic regulation.
Authors:
Maarten de Mulder; Rohit M Oemrawsingh; Frank Stam; Eric Boersma; Victor A W M Umans
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  8     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-03     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-70; quiz 71     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical Centre Alkmaar, Alkmaar, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood*,  complications
Humans
Hyperglycemia / blood*,  complications,  drug therapy*
Hypoglycemic Agents / therapeutic use*
Netherlands
Questionnaires
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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