title: Impact of stress hyperglycemia on myocardial salvage following successfully recanalized primary acute myocardial infarction.
abstract: BACKGROUND
  Elevated blood glucose on admission may worsen outcome after acute myocardial infarction (AMI). No relationship has been identified between admission blood glucose level and myocardial salvage in patients with AMI.
  
  
  RESULTS
  This study assessed 150 consecutive patients with a first AMI who underwent percutaneous coronary intervention within 24 h from onset of symptoms. Plasma blood glucose was measured on admission. Stress hyperglycemia was defined as blood glucose ≥10 mmol/L (180 mg/dl). The extent of myocardial salvage 7 days after AMI was evaluated on cardiovascular magnetic resonance imaging (CMRI) as the difference between areas of myocardium at risk (T2-weighted hyperintense lesion) and areas of late gadolinium enhancement. The association between stress hyperglycemia and myocardial salvage index (MSI) was investigated in patients with and without diabetes. Among non-diabetic patients, MSI was lower in those with stress hyperglycemia than in those without. No significant difference in MSI was noted between diabetes patients with or without stress hyperglycemia. On multivariate analysis, stress hyperglycemia in patients without diabetes was an independent predictor of MSI.
  
  
  CONCLUSIONS
  Stress hyperglycemia affects MSI, indicating that the manipulation of glucose levels could be a potential therapeutic target for salvaging ischemic damage.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Teraguchi
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009206:Myocardium / Q000378:metabolism; D013312:Stress, Physiological
chemical_list: D001786:Blood Glucose