Stress hyperglycemia in acute ST-segment elevation myocardial infarction is a marker of left ventricular remodeling

Djordjevic-Radojkovic, Danijela; Koraćević, Goran; Stanojević, Dragana; Damjanović, Miodrag; Apostolović, Svetlana; Pavlović, Milan

doi:10.3109/17482941.2013.781190

Cited by 12 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They demonstrated that corrected thrombolysis in myocardial infarction (TIMI) frame counts were significantly higher in patients with acute hyperglycemia and were independently associated with plasma glucose level. Moreover, SH is a marker of left ventricular (LV) remodeling, which may help explain postinfarction transition to LV failure 35 . The presence of acute hyperglycemia was associated with the impairment of epicardial coronary flow after primary stent implantation.…”

Section: The Presence Of Stress Hyperglycemia Association With Almostmentioning

confidence: 99%

Stress hyperglycemia in acute myocardial infarction

Koraćević

Vasiljevic

Veličković‐Radovanović

et al. 2014

VOJNOSANIT PREGL

Self Cite

View full text Add to dashboard Cite

show abstract

Section: The Presence Of Stress Hyperglycemia Association With Almostmentioning

confidence: 99%

Stress hyperglycemia in acute myocardial infarction

Koraćević

Vasiljevic

Veličković‐Radovanović

et al. 2014

VOJNOSANIT PREGL

Self Cite

View full text Add to dashboard Cite

show abstract

“…Rezultai našeg istraživanja pokazuju da je glikemija pri prijemu ≥8 mmol/L kod pacijenata bez prethodnog DM, povećala rizik intrahospitalnog mortaliteta 6,4 puta, a jednogodišnjeg mortaliteta oko 2 puta. 20 U retrospekivnoj analizi urađenoj na 141680 starijih pacijenata sa AIM, hiperglikemija je bila česta, retko treirana, i udružena sa značajno većim rizikom intrahospitalnog i jednogodišnjeg mortaliteta kod pacijenata bez prethodno poznatog DM u odnosu na dijabeičare. Visok rizik perzisira i nakon korekcije za komorbiditete (prethodni infarkt i srčana insuicijencija) i težinu bolesi (viša Killip klasa, veći pik CK, viši nivo kreainina, niža EF), 2 što upućuje na moguću kauzalnost.…”

Section: Intrahospitalni I Jednogodišnji Mortalitetunclassified

“…31 U našem istraživanju, na 275 pacijenata sa STEMI, pokazano je da SH uiče na remodelovanje LK kod pacijenata bez prethodnog DM, procenjeno ehokardiografski značajnim povećanjem EDV tokom godinu dana. 20 Može se zaključii da među do sada objavljenim istraživanjima na temu povezanosi SH i remodelovanja LK postoje brojne metodološke razlike. Uključivani su pacijenta sa STEMI, ali i svi pacijeni sa AIM ili samo pacijeni sa STEMI prednjeg zida, pacijeni sa uspešnom reperfuzijom ili bez reperfuzije, pacijeni lečeni trombolizom ili primarnom PCI.…”

Section: Funkcija Leve Komoreunclassified

“…Funkcija LK procenjivana je ehokardiografski, levom ventrikulograijom ili magnetnom rezonancom. U samo 4 istraživanja 20,27,28,31 korišćena je ehokardiografija, koja je najpogodnija i najdostupnija metoda u realnim uslovima. Ukupno gledano, u 6 studija je nađeno da postoji uicaj SH na posinfarktno remodelovanje LK 20,25,26,27,29,30 , dok u 2 to nije potvrđeno.…”

Section: Funkcija Leve Komoreunclassified

“…U samo 4 istraživanja 20,27,28,31 korišćena je ehokardiografija, koja je najpogodnija i najdostupnija metoda u realnim uslovima. Ukupno gledano, u 6 studija je nađeno da postoji uicaj SH na posinfarktno remodelovanje LK 20,25,26,27,29,30 , dok u 2 to nije potvrđeno. 28,31 Rezultai većeg broja studija, kao i naši, da kod pacijenata sa SH u AIM dolazi češće do remodelovanja LK, mogu podržai stav da metaboličke abnormalnosi (SH) mogu dovesi do strukturnih promena i kliničkog pogoršanja (srčane insuicijencije i većeg mortaliteta).…”

Section: Funkcija Leve Komoreunclassified

See 2 more Smart Citations

Stress hyperglycemia in ST elevation myocardial infarction

Đorđević-Radojković¹,

Koraćević²,

Damjanović³

et al. 2014

Srce i krvni sudovi

View full text Add to dashboard Cite

Klinika za kardiovaskularne bolesi, KC Niš Pregledni radStres hiperglikemija (SH) predstavlja povišen nivo glukoze u krvi, kao rezultat neurohumoralne akivacije u telu izloženom stresu. U akutnom infarktu miokarda (AIM) ona je udružena sa većim rizikom intrahospitalnog mortaliteta, ali još postoje kontroverze da li je marker povećanog dugoročnog rizika. Različiim mehanizmima hiperglikemija može imai direktne štetne efekte na ishemijski miokard, a insulinom posignuta normoglikemija može da umanji neke od njih. Visoka glikemija je značajniji prediktor lošeg ishoda kod pacijenata bez prethodnog DM nego kod dijabeičara. SH nije samo marker lošeg stanja već dovodi do pogoršanja funkcije LK tokom AIM. Pacijenima sa SH treba uradii HbA1c. Ukoliko je ≥ 6,5 %, smatra se da je pacijent dijabeičar. Ako postoji hiperglikemija na prijemu bez prethodnog DM, a HbA1c je <6,5 %, preporučuje se OGTT, 7 do 28 dana nakon AKS. Tokom hospitalizacije u jedinici intenzivne nege, insulin treba dai svim pacijenima sa glikemijom na prijemu ≥10,0 mmol/L, do ciljnih vrednosi 7,7-10 mmol/L. hiperglikemija, STEMI Sažetak Ključne rečiAutor za korespondenciju: Danijela Đorđević Radojković, Klinika za KVB, KC Niš, Abstract Stress hyperglycemia in ST elevaion myocardial infarcion Clinic for cardiovascular diseases, Clinical center of NisStress hyperglycemia (SH) is elevated plasma glucose level as result of acivaion of neurohormonal processes in the body exposed to stress. SH in AMI is associated with high risk of in-hospital mortality. It is sill controversial if SH is the marker of high post-hospital risk. Hyperglycemia can have direct detrimental efects on ischemic myocardium through diferent mechanisms. Normoglycemia achieved with insulin can reduce some of them. Hyperglycemia is more important predictor of bed outcome in paients without diabetes. SH is not only a marker of bed condiion, but causal factor of worsening LV funcion in AMI. In paients with SH, it is necessary to perform HbA1c. If it is ≥ 6.5%, paient is diabeic. If it is <6.5%, it is necessary to perform OGTT 7-28 days ater ACS. During hospitalizaion in ICU, paients with glycemia on admission ≥10.0 mmol/L should be treated with insulin to the targrt values 7.7-10 mmol/L.

show abstract

Splenic leukocytes mediate the hyperglycemic exacerbation of myocardial infarct size in mice

et al. 2015

View full text Add to dashboard Cite

Acute hyperglycemia during acute myocardial infarction is associated with worse myocardial injury and increased mortality. Using a mouse model of myocardial ischemia/reperfusion injury, we tested the hypothesis that acute hyperglycemia activates splenic leukocytes and subsequently exacerbates myocardial infarct size. We then examined whether the adverse effects of hyperglycemia could be attenuated by a potent anti-inflammatory agent (an agonist of the adenosine A2A receptor) administered immediately prior to reperfusion. C57BL6 (WT) mice underwent 30-min LAD occlusion and 60-min reperfusion with or without prior splenectomy. Acute hyperglycemia before ischemia increased myocardial infarct size (IS) by 43% (p < 0.05). Splenectomy before ischemia did not change IS (vs. control, p = NS) but did serve to prevent the exacerbation of IS by hyperglycemia. Acute hyperglycemia activated splenic leukocytes by increasing formyl peptide receptor expression and reactive oxygen species production before ischemia, and enhanced splenic neutrophil release with resultant peripheral neutrophilia and increased myocardial neutrophil infiltration during reperfusion. Acute adoptive transfer of splenic leukocytes to splenectomized mice before ischemia restored the hyperglycemic exacerbation of infarct size. ATL146e, an adenosine 2A receptor (A2AR) agonist, abolished neutrophilia during reperfusion and reduced IS in hyperglycemic mice. ATL146e also reduced IS in splenectomized hyperglycemic mice with transfer of WT splenic leukocytes, but not with transfer of splenic leukocytes from A2AR knockout mice. Acute hyperglycemia prior to myocardial ischemia and reperfusion exacerbates IS by activating splenic leukocytes. ATL146e administered at reperfusion suffices to abrogate the hyperglycemic exacerbation of IS by acting on A2ARs on splenic leukocytes.

show abstract

Stress hyperglycemia in acute ST-segment elevation myocardial infarction is a marker of left ventricular remodeling

Abstract: SH is associated with high in-hospital mortality risk and it could be marker of LV remodeling (significant increase of EDV during one year).

Cited by 12 publications

References 24 publications

Stress hyperglycemia in acute myocardial infarction

Stress hyperglycemia in acute myocardial infarction

Stress hyperglycemia in ST elevation myocardial infarction

Splenic leukocytes mediate the hyperglycemic exacerbation of myocardial infarct size in mice

Contact Info

Product

Resources

About