The prognostic role of in-hospital peak glycemia in stemi patients with and without diabetes

Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Attanà, Paola; Picariello, Claudio; Gensini, Gian Franco

doi:10.1007/s00592-011-0343-4

Cited by 14 publications

(6 citation statements)

References 31 publications

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“…Hyperglycemia has been linked with more complications during hospitalization and poor outcomes in AMI patients. Lazzeri et al [44] concluded that in STEMI patients, in-hospital peak glycemia is negatively correlated with long-term survival. Besides that, another study had also confirmed that acute hyperglycemia is a predictor of CI-AKI and in-hospital mortality [45].…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Zhu

Liu

2020

BMC Cardiovasc Disord

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Background: Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controversial in patients submitted to primary PCI. This study aimed to assess continuous metformin therapy on kidney function in diabetic patients undergoing coronary intervention. Methods: Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m 2 . According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI. Results: No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m 2 [p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission. Conclusions: The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m 2 did not increase the risk of CI-AKI.

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Section: Discussionmentioning

confidence: 99%

Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Zhu

Liu

2020

BMC Cardiovasc Disord

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“…A possible limitation of our study is represented by the small number of enrolled patients. However, our series comprises consecutive CS patients, all managed by the same medical team according to implemented protocols for glucose management [Richards and Wilcox, 2014; Lazzeri et al . 2012].…”

Section: Discussionmentioning

confidence: 99%

Early glucose variability in cardiogenic shock following acute myocardial infarction: a pilot study

Lazzeri¹,

Valente²,

Chiostri³

et al. 2015

Therapeutic Advances in Cardiovascular Disease

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“…40 Peak glycemia in patients undergoing PCI was a predictor of early death in patients without diabetes though it affects long-term survival in patients with and without diabetes. 41 In a study of patients with STEMI undergoing PCI, admission glucose level was a predictor of 30-day mortality, but not late mortality, in both patients with and without diabetes. 42 Conversely, in patients with AMI, admission blood glucose was a predictor of long-term mortality regardless of diabetic status.…”

Section: Question 1: Are Admission Glucose and Glycated Haemoglobin Pmentioning

confidence: 97%

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Avogaro

Bonora

Consoli

et al. 2019

Diabetes and Vascular Disease Research

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Diabetes is a common comorbidity in patients hospitalized for an acute coronary syndrome event, and prevalence is increasing. Among patients hospitalized with acute myocardial infarction, diabetes can be an independent predictor of mortality and new cardiovascular events; both short- and long-term outcomes are worse for patients with diabetes relative to those without, and undiagnosed diabetes is associated with greater mortality. The impact of glycemic control on cardiovascular outcomes and the best approach to treat hyperglycemia upon hospital admission for acute coronary syndrome in patients with or without known diabetes remain open questions. This review assesses available evidence for hyperglycemia management at the time of admission for acute coronary syndrome and, thereafter, finds that (1) admission plasma glucose plays a role in predicting adverse events, especially in patients with unknown diabetes; (2) glycated haemoglobin is a likely predictor of events in patients with unknown diabetes; and (3) hypoglycemia at the time of acute myocardial infarction hospital admission is an important predictor for mortality in patients with and without diabetes. Whether glucose-targeted insulin and glucose infusion have advantages over glucose–insulin–potassium infusion remains controversial. Evidence for the effect of novel glucose-lowering agents used at the time of an acute cardiovascular event is limited and requires more dedicated studies.

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The prognostic role of in-hospital peak glycemia in stemi patients with and without diabetes

Cited by 14 publications

References 31 publications

Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Early glucose variability in cardiogenic shock following acute myocardial infarction: a pilot study

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

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