Document Detail


What glucose target should we aim for in myocardial infarction?
MedLine Citation:
PMID:  18339441     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hyperglycaemia in the period following myocardial infarction is associated with increased mortality and there is some evidence that its treatment can improve survival. However, it remains unclear as to what the ideal glucose targets might be. This study examined observational data taken from a previously reported randomised controlled trial of insulin therapy for myocardial infarction (The Hyperglycaemia: Intensive Insulin Infusion In Infarction Study), to determine optimal glucose levels for this period. Capillary glucose readings were recorded at 8 standard time points for 234 subjects in first 24h after myocardial infarction. Survival over 6 months was analysed according to whether 80% of each subject's glucose readings were below specified glucose thresholds (Achievers) or not (Non-Achievers). We found that the glucose threshold at which there was greatest separation in mortality between Achievers and Non-Achievers was at 8mmol/L [144mg/dL] (6 month mortality 1.6% vs. 9.1%, p=0.05). Therefore subjects who maintained the majority of their blood glucose levels below 8mmol/L following myocardial infarction had optimal survival outcomes. We suggest that this might be an appropriate glucose target to aim for in the peri-infarct period.
Authors:
N W Cheung; V W Wong; M McLean
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-03-12
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  80     ISSN:  1872-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-13     Completed Date:  2008-08-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  411-5     Citation Subset:  IM    
Affiliation:
Centre for Diabetes & Endocrinology Research, Westmead Hospital and University of Sydney, Westmead, NSW 2145, Australia. wah@westgate.wh.usyd.edu.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Glucose / drug effects,  metabolism*
Diabetic Angiopathies / blood,  drug therapy
Female
Humans
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Male
Middle Aged
Myocardial Infarction / blood*,  drug therapy,  mortality
Survival Analysis
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin

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


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