Persistent hyperglycemia is associated with left ventricular dysfunction in patients with acute myocardial infarction.
BACKGROUND
The relationship of changes in blood glucose concentrations after admission to left ventricular (LV) dysfunction in patients with recanalized anterior acute myocardial infarction (AMI) remains unclear.


RESULTS
Blood glucose concentrations were measured on admission and 24 h after symptom onset in 210 patients with recanalized anterior AMI within 6 h of symptom onset. Of them, 142 had hyperglycemia on admission, defined as a blood glucose >or=8.9 mmol/L, and 68 patients did not. Among the patients with admission hyperglycemia, 49 had persistent hyperglycemia, defined as a blood glucose >or=8.9 mmol/L 24 h after onset, and 93 did not. The incidences of myocardial blush grade of 0/1 after recanalization indicating impaired myocardial perfusion (71%), and peak creatine kinase concentration (5,631+/-2,855 mU/ml) were higher and predischarge LV function (43+/-11%) was lower in patients with persistent hyperglycemia than in those without (p<0.01). Multivariate analysis showed that persistent hyperglycemia was independently associated with LV dysfunction, defined as a predischarge LV ejection fraction <or=40% (odds ratio 7.38, p=0.001).


CONCLUSIONS
Persistent hyperglycemia at 24 h after symptom onset is associated with LV dysfunction before discharge in patients with recanalized anterior AMI.
Kosuge
Masami
M
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Ishikawa
Toshiyuki
T
Shimizi
Tomoaki
T
Hibi
Kiyoshi
K
Toda
Noritaka
N
Tahara
Yoshio
Y
Kanna
Masahiko
M
Tsukahara
Kengo
K
Okuda
Jyunn
J
Nozawa
Naoki
N
Umemura
Satoshi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology*; D016277:Ventricular Function, Left
D001786:Blood Glucose