title: Stress hyperglycaemia is an independent predictor of left ventricular remodelling after first anterior myocardial infarction in non-diabetic patients.
abstract: OBJECTIVE
  Stress hyperglycaemia (SH) is associated with adverse outcome in patients with acute myocardial infarction (MI) but the mechanisms underlying this association are unknown. Our hypothesis was that SH on admission for acute MI may be associated with left ventricular (LV) remodelling.
  
  
  RESULTS
  We analysed LV remodelling in 162 non-diabetic patients with anterior MI. SH was defined as a glycaemia on admission >or=7 mmol/L. Systematic echocardiographic follow-up was performed at 3 months and 1 year after MI. The changes in end-diastolic volume (EDV) and end-systolic volume (ESV) from baseline to 1 year were 11.4 +/- 16.5 and 6.4 +/- 12.4 ml/m(2), respectively, in patients with SH vs. 1.9 +/- 11.1 and 0.2 +/- 8.5 ml/m(2), respectively, in patients without SH (both P < 0.0001). When LV remodelling was defined as a >20% increase in EDV, it was observed in 46% patients in the SH group vs. 19% patients in the no SH group (P = 0.0008). By multivariable analysis, baseline wall motion score index (P = 0.001) and SH (P = 0.009) were independently associated with changes in EDV. SH was an independent predictor of LV remodelling [adjusted OR: 3.22 (1.31-7.94)].
  
  
  CONCLUSIONS
  SH is a major and independent predictor of LV remodelling after anterior MI in non-diabetic patients.
authors.affiliation: Service de Cardiologie C, Hôpital Cardiologique, Centre Hospitalier Régional et Universitaire de Lille, Boul, Lille Cedex, France. cbauters@chru-lille.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
authors.forename: Pierre V
authors.initials: PV
authors.lastname: Ennezat
authors.forename: Olivier
authors.initials: O
authors.lastname: Tricot
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Lauwerier
authors.forename: Robert
authors.initials: R
authors.lastname: Lallemant
authors.forename: Hassan
authors.initials: H
authors.lastname: Saadouni
authors.forename: Philippe
authors.initials: P
authors.lastname: Quandalle
authors.forename: Olivier
authors.initials: O
authors.lastname: Jaboureck
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
mesh_terms: D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D015588:Observer Variation; D013312:Stress, Physiological / Q000150:complications* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology*