Glycemic Variability Determined by Continuous Glucose Monitoring System Predicts Left Ventricular Remodeling in Patients With a First ST-Segment Elevation Myocardial Infarction.
BACKGROUND
Impaired glucose metabolism plays an important role in patients with acute myocardial infarction, but the clinical significance of glycemic variability (GV) early after the onset of ST-segment elevation myocardial infarction (STEMI) remains to be fully elucidated.


RESULTS
We prospectively investigated the clinical impact of GV, as determined by a continuous glucose monitoring system (CGMS), on left ventricular remodeling (LVR) assessed by cardiac magnetic resonance imaging (CMR) in 69 patients (63±13 years, 59 men) with a first reperfused STEMI within 12 h of onset. All patients were equipped with a CGMS when in a stable phase after admission and underwent repeat CMR at baseline and 7 months follow-up. Patients were divided into 2 groups according to the mean amplitude of glycemic excursions (MAGE). Patients in the upper tertile of MAGE were categorized as group High (H) and the other two-thirds as group Low (L). LVR was deﬁned as an absolute increase in left ventricular end-diastolic volume index of ≥20%. LVR more frequently occurred in group H than in group L (56% vs. 11%, P<0.001). Multivariate analysis showed the higher MAGE group was an independent predictor of LVR in the chronic phase (odds ratio, 13.999; 95% confidence interval, 3.059 to 64.056; P=0.001).


CONCLUSIONS
MAGE early after the onset of STEMI identified patients with LVR in the chronic phase.
Division of Cardiology, Yokohama City University Medical Center.
Masaomi
M
Gohbara
Noriaki
N
Iwahashi
Shunsuke
S
Kataoka
Yoshikazu
Y
Hayakawa
Kentaro
K
Sakamaki
Eiichi
E
Akiyama
Nobuhiko
N
Maejima
Kengo
K
Tsukahara
Kiyoshi
K
Hibi
Masami
M
Kosuge
Toshiaki
T
Ebina
Satoshi
S
Umemura
Kazuo
K
Kimura
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D011859:Radiography; D020257:Ventricular Remodeling
D001786:Blood Glucose