title: Impact of acute hyperglycemia on left ventricular function after reperfusion therapy in patients with a first anterior wall acute myocardial infarction.
abstract: OBJECTIVE
  This study was undertaken to assess the relationship between acute hyperglycemia and left ventricular function after reperfusion therapy for acute myocardial infarction (AMI).
  
  
  METHODS
  This study consisted of 529 patients with a first anterior wall AMI who underwent coronary angiography followed by coronary angioplasty or thrombolysis within 12 hours after the onset of chest pain. Plasma glucose was measured at the time of hospital admission. Acute hyperglycemia was defined as plasma glucose >10 mmol/L.
  
  
  RESULTS
  Although acute hyperglycemia was associated with both lower acute left ventricular ejection fraction (LVEF) (46% +/- 12% vs 48% +/- 10%, P =.026) and lower predischarge LVEF (51% +/- 15% vs 56% +/- 15%, P =.001), the difference was more pronounced in the latter and the change in LVEF was significantly smaller in patients with acute hyperglycemia (4.8% +/- 11.2% vs 8.0% +/- 13.8%, P =.022). Multivariable analysis showed that there was a significant correlation between plasma glucose and impaired predischarge LVEF, even after adjustment of acute LVEF (r = -0.13, P =.005). Thirty-day mortality tended to be higher in patients with acute hyperglycemia than in patients without (7.1% vs 3.5%, P =.06). Multivariable analysis showed that plasma glucose (per 1 mmol/L increase) was an independent predictor of 30-day mortality after AMI (odds ratio 1.12, 95% CI 1.03-1.22, P =.009).
  
  
  CONCLUSIONS
  Acute hyperglycemia was independently associated with impaired left ventricular function and higher 30-day mortality after AMI. These results may provide a potential explanation for poor outcomes of patients with AMI and acute hyperglycemia.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan. ishifami@fb3.so-net.ne.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Kenji
authors.initials: K
authors.lastname: Nishioka
authors.forename: Takashi
authors.initials: T
authors.lastname: Umemura
authors.forename: Shuji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D015912:Thrombolytic Therapy; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*