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Admission glucose and left ventricular systolic function in non-diabetic patients with acute myocardial infarction

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Abstract

Carbohydrate metabolism disorder in patients hospitalized due to acute ST-segment elevation myocardial infarction (STEMI) is associated with poor outcome. The association is even stronger in non-diabetic patients compared to the diabetics. Poor outcome of patients with elevated parameters of carbohydrate metabolism may be associated with negative impact of these disorders on left ventricular (LV) function. The aim of the study was to determine the impact of admission glycemia on LV systolic function in acute phase and 6 months after myocardial infarction in STEMI patients treated with primary angioplasty, without carbohydrate disorders. The study group consisted of 52 patients (9 female, 43 male) aged 35–74 years, admitted to the Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, due to the first STEMI treated with primary coronary angioplasty with stent implantation, without diabetes in anamnesis and carbohydrate metabolism disorders diagnosed during hospitalization. Echocardiography was performed in all patients in acute phase and 6 months after MI. Plasma glucose were measured at hospital admission. In the subgroup with glycemia ≥7.1 mmol/l, in comparison to patients with glycemia <7.1 mmol/l, significantly lower ejection fraction (EF) was observed in acute phase of MI (44.4 ± 5.4 vs. 47.8 ± 6.3 %, p = 0.04) and trend to lower EF 6 months after MI [47.2 ± 6.5 vs. 50.3 ± 6.3 %, p = 0.08 (ns)]. Higher admission glycemia in patients with STEMI and without carbohydrate metabolism disturbances, may be a marker of poorer prognosis resulting from lower LV ejection fraction in the acute phase and in the long-term follow-up.

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References

  1. Velazquez EJ, Francis GS, Armstrong PW, Aylward PE, Diaz R, O’Connor CM, White HD, Henis M, Rittenhouse LM, Kilaru R, van Gilst W, Ertl G, Maggioni AP, Spac J, Weaver WD, Rouleau JL, McMurray JJ, Pfeffer MA, Califf RM, VALIANT registry (2004) An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction: the VALLIANT Registry. Eur Heart J 25:1911–1919

    Article  PubMed  Google Scholar 

  2. Ho KK, Pinsky JL, Kannel WB, Levy D (1993) The epidemiology of heart failure: the Framingham study. J Am Coll Cardiol 22(4):6A–13A

    Article  CAS  PubMed  Google Scholar 

  3. Oh JK (2007) Echocardiography in heart failure: beyond diagnosis. Eur J Echocardiogr 8:4–14

    Article  CAS  PubMed  Google Scholar 

  4. Cintron G, Johnson G, Francis G, Cobb F, Cohn JN (1993) Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation 87(6 Suppl):VI17–VI23

  5. Weir A, McMurray J, Velazquez E (2006) Epidemiology of heart failure and left ventricular systolic dysfunction after acute myocardial infarction: prevalence, clinical characteristics, prognostic importance. Am J Cardiol 97:13–25

    Article  Google Scholar 

  6. Cleland J, Torabi A, Khan N (2005) Epidemiology and management of heart failure and left ventricular systolic dysfunction in the aftermath of a myocardial infarction. Heart 91(Suppl 2):ii7–ii13

  7. Kümler T, Gislason G, Kober L, Torp-Pedersen C (2010) Persistence of the prognostic importance of left ventricular systolic function and heart failure after myocardial infarction: 17-year follow-up of the TRACE register. Eur J Heart Fail 12:805–811

    Article  PubMed  Google Scholar 

  8. Shaw LJ, Peterson ED, Kesler K, Hasselblad V, Califf RM (1996) A metaanalysis of predischarge risk stratification after acute myocardial infarction with stress electrocardiographic, myocardial perfusion, and ventricular function imaging. Am J Cardiol 78:1327–1337

    Article  CAS  PubMed  Google Scholar 

  9. Korup E, Kober L, Poulsen S (1999) Prognostic usefulness of repeated echocardiographic evaluation after acute myocardial infarction. TRACE Study Group. TRAndolapril cardiac evaluation. Am J Cardiol 83:1559–1562

    Article  CAS  PubMed  Google Scholar 

  10. Hamdan A, Kornowski R, Solodky A, Fuchs S, Battler A, Assali AR (2006) Predictors of left ventricular dysfunction in patients with first acute anterior myocardial infarction undergoing primary angioplasty. Isr Med Assoc J 8(8):532–535

    PubMed  Google Scholar 

  11. Capes SE, Hunt D, Malmberg K, Gerstein HC (2000) Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 355(9206):773–778

    Article  CAS  PubMed  Google Scholar 

  12. Zuanetti G, Latini R, Maggioni AP, Santoro L, Franzosi MG (1993) Influence of diabetes on mortality in acute myocardial infarction: date from GISSI - 2 study. J Am Coll Cardiol 22(7):1788–1794

  13. Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 22:233–240

    Article  CAS  PubMed  Google Scholar 

  14. Wong VW, Ross DL, Park K, Boyages SC, Cheung NW (2004) Hyperglycemia: still an important predictor of adverse outcomes following AMI in the reperfusion era. Diabetes Res Clin Pract 64(2):85–91

  15. Straumann E, Kurz DJ, Muntwyler J, Stettler I, Furrer M, Naegeli B, Frielingsdorf J, Schuiki E, Mury R, Bertel O, Spinas GA (2005) Admissionglucose concentrations independently predict early and late mortality in patients with acute myocardial infarction treated by primary or rescue percutaneous coronary intervention. Am Heart J 150(5):1000–1006

    Article  CAS  PubMed  Google Scholar 

  16. Stranders I, Diamant M, van Gelder RE, Spruijt HJ, Twisk JW, Heine RJ, Visser FC (2004) Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch Intern Med 164(9):982–988

    Article  PubMed  Google Scholar 

  17. Sanjuán R, Núñez J, Blasco ML, Miñana G, Martínez-Maicas H, Carbonell N, Palau P, Bodí V, Sanchis J (2011) Prognostic implications of stress hyperglycemia in acute ST elevation myocardial infarction. Prospective observational study. Rev Esp Cardiol 64(3):201–207

  18. Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H, Cox JL, ICONS investigators (2002) Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? J Am Coll Cardiol 40:1748–1754

  19. Kadri Z, Danchin N, Vaur L, Cottin Y, Gueret P, Zeller M, Lablanche JM, Blanchard D, Hanania G, Genes N, Cambou JP; USIC 2000 Investigators (2005) Major impact of admission glycaemia on 30 day Coronary Syndrome Study Investigators. Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era. Am Heart J 150(4):814–820

  20. Ishihara M, Kojima S, Sakamoto T, Asada Y, Tei C, Kimura K, Miyazaki S, Sonoda M, Tsuchihashi K, Yamagishi M, Ikeda Y, Shirai M, Hiraoka H, Inoue T, Saito F, Ogawa H; Japanese Acute Coronary Syndrome Study (JACSS) Investigators (2005) Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era. Am Heart J 150:814–820

  21. Ishihara M, Kojima S, Sakamoto T, Kimura K, Kosuge M, Asada Y, Tei C, Miyazaki S, Sonoda M, Tsuchihashi K, Yamagishi M, Shirai M, Hiraoka H, Honda T, Ogata Y, Ogawa H. Japanese Acute Coronary Syndrome Study (JACSS) Investigators (2009) Comparison of blood glucose values on admission for acute myocardial infarction in patients with versus without diabetes mellitus. Am J Cardiol 104(6):769–774

  22. Timmer JR, Van der Horst IC, Ottervanger JP, Henriques J, Hoorntje J, de Boer M, Suryapranata H, Zijlstra F (2004) Prognostic value of admission glucose in nondiabetic patients with myocardial infarction. Am Heart J 148:399–404

    Article  CAS  PubMed  Google Scholar 

  23. Meisinger C, Hormann A, Heier M, Kuch B, Lowel H (2006) Admission blood glucose and adverse outcomes in non-diabetic patients with myocardial infarction in the reperfusion era. Int J Cardiol 113:229–235

    Article  PubMed  Google Scholar 

  24. AinlaT Baburin A, Teesalu R, Rahu M (2005) The association between hyperglycemia on admission and 180-day mortality in acute myocardial infarction patients with and without diabetes. Diabet Med 22:1321–1325

    Article  Google Scholar 

  25. Norhammar A, Ryden L, Malmberg K (1999) Admission plasma glucose. Independent risk factor for long-term prognosis after myocardial infarction even in non-diabetic patients. Diabetes Care 22:1827–1831

    Article  CAS  PubMed  Google Scholar 

  26. Monteiro S, Monteiro P, Goncalves F, Freitas M, Providencia LA (2010) Hyperglycemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. Eur J Cardiovasc Prev Rehabil 17(2):155–159

  27. Tenerz A, Nilson G, Forberg R, Ohrvik J, Malmberg K, Berne C, Leppert J (2003) Basal glucometabolic status has an impact on long-term prognostic following an acute myocardial infarction in non-diabetic patients. J Intern Med 254:494–503

    Article  CAS  PubMed  Google Scholar 

  28. American Diabetes Association (2012) Standards of medical care in diabetes 2012. Diabetes Care 35(suppl. 1):S11–S63

    Google Scholar 

  29. Schiller N, Shah P, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I (1989) Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiograph 2:358–367

    Article  CAS  Google Scholar 

  30. Yousef ZR, Redwood SR, Marber MS (2000) Postinfarction left ventricular remodeling: where are the theories and trials leading us? Heart 83(1):76–80

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Kurisu S, Nishioka K, Umemura T, Nakamura S, Yoshida M (2003) Impact of acute hyperglycemia on left ventricular function after reperfusion therapy in patients with a first anterior wall acute myocardial infarction. Am Heart J 146(4):674–678

    Article  CAS  PubMed  Google Scholar 

  32. Kosuge M, Kimura K, Ishikawa T, Shimizi T, Hibi K, Toda N, Tahara Y, Kanna M, Tsukahara K, Okuda J, Nozawa N, Umemuyra S (2005) Persistent hyperglycemia is associated with left ventricular dysfunction in patients with acute myocardial infarction. Circ J 69(1):23–28

    Article  PubMed  Google Scholar 

  33. Gąsior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M, Hawranek M, Wilczek K, Szyguła-Jurkiewicz B, Lekston A, Kalarus Z, Strojek K, Gumprecht J, Poloński L (2008) Effect of blood glucose levels on prognosis in acute myocardial infarction in patients with and without diabetes, undergoing percutaneous coronary intervention. Cardiol J 15(5):422–430

    PubMed  Google Scholar 

  34. Bauters C, Ennezat PV, Tricot O, Lauwerier B, Lallemant R, Saadouni H, Quandalle P, Jaboureck O, Labmblin N, Le Tourneau T, REVE Investigators (2007) Stress hyperglycemia is an independent predictor of left ventricular remodeling after first anterior myocardial infarction in non-diabetic patients. Eur Heart J 28(5):546–552

    Article  CAS  PubMed  Google Scholar 

  35. Pitsavos Ch, Chrysohoou Ch, Aggelopoulos P, Skoumas J, Tsiamis E, Panagiotakos D, Stefanadis Ch (2010) Serum glucose level at hospital admission correlates with left ventricular systolic dysfunction in nondiabetic, acute coronary patients: the Hellenic Heart Failure Study. Heart Vessels 25:209–216

    Article  PubMed  Google Scholar 

  36. Salmasi AM, Frost P, Dancy M (2006) Is glycated haemoglobin a sensitive index to identify left ventricular dysfunction 2 months after acute myocardial infarction in normotensive subject? Int J Cardiol 110(1):67–73

    Article  PubMed  Google Scholar 

  37. Sinnaeve PR, Steg PG, Fox KA, Van de Werf F, Montalescot G, Granger CB, Knobel E, Anderson FA, Dabbous OH, Avezum A, GRACE Investigators (2009) Association of elevated fasting glucose with increased short-term and 6-month mortality in ST-segment elevation and non-ST-segment elevation acute coronary syndromes: the Global Registry of Acute Coronary Events. Arch Intern Med 169(4):402–409

    Article  CAS  PubMed  Google Scholar 

  38. Cruz-Gonzales I, Chia S, Raffel O, Sanchez-Ledesma M, Senatore F, Wackers F, Nathan D, Jang I (2010) Hyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. Diab Res Clin Pract 88:97–102

    Article  Google Scholar 

  39. Eitel I, Hintze S, de Waha S, Fuernau G, Lurz P, Desch S, Schuler G, Thiele H (2012) Prognostic impact of hyperglycemia in nondiabetic and diabetic patients with ST-elevation myocardial infarction: insights from contrast-enhanced magnetic resonance imaging. Circ Cardiovasc Imaging 5:708–718

    Article  PubMed  Google Scholar 

  40. Jensen CJ (2011) Impact of hyperglycemia at admission in patients with acute ST-segment elevation myocardial infarction as assessed by contrast-enhanced MRI. Clin Res Cardiol 100(8):649–659

    Article  CAS  PubMed  Google Scholar 

  41. Risso A, Mercuri F, Quagliaro L, Damante G, Ceriello A (2001) Intermittent high glucose enhances apoptosis in human umbilical vein endothelial cells in culture. Am J Physiol Endocrinol Metab 281:E924–E930

  42. Mulvihill N, Foley J (2002) Inflammation in acute coronary syndromes. Heart 87(3):201–204

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Oswald GA, Smith CC, Delamothe AP (1988) Raised concentrations of glucose and adrenaline and increased in vivo platelet activation after myocardial infarction. Br Heart J 59:663–671

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Ceriello A (1997) Acute hyperglycemia and oxidative stress generation. Diabet Med 14:S45–S49

    Article  PubMed  Google Scholar 

  45. Oliver MF, Opie LH (1994) Effects of glucose and fatty acids on myocardial ischaemia and arrhythmias. Lancet 343(8890):155–158

    Article  CAS  PubMed  Google Scholar 

  46. Iwakura K, Ito H, Ikushima M, Kawano S, Okamura A, Asano K, Kuroda T, Tanaka K, Masuyama T, Hori M, Fujii K (2003) Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction. J Am Coll Cardiol 41(1):1–7

    Article  CAS  PubMed  Google Scholar 

  47. Shen XH, Jia SQ, Li HW (2006) The influence of admissionglucose on epicardial and microvascular flow after primary angioplasty. Chin Med J (Engl) 119(2):95–102

    Google Scholar 

  48. Abdelmoneim S, Hagen M, Mendrick E, Pattan V, Wong B, Norby B, Roberson T, Szydel T, Basu R, Basu A, Mulvagh S (2013) Acute hyperglycemia reduces myocardial blood flow reserve and the magnitude of reduction is associated with insulin resistance: a study in nondiabetic humans using contrast echocardiography. Heart Vessels 28(6):757–768

    Article  PubMed  Google Scholar 

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The authors declare that there are no financial or other relationships that could lead to a conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, Regional Specialist Hospital, Grudziadz, Poland

    Joanna Gierach

  2. Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

    Iwona Świątkiewicz, Marek Woźnicki, Grzegorz Grześk, Adam Sukiennik, Marek Koziñski & Jacek Kubica

  3. Department of Endocrinology and Diabetology, Collegium Medicum, Nicolaus Copernicus University, ul. Marii Skłodowskiej-Curie 9, 85-094, Bydgoszcz, Poland

    Marcin Gierach

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  1. Joanna Gierach
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Gierach, J., Gierach, M., Świątkiewicz, I. et al. Admission glucose and left ventricular systolic function in non-diabetic patients with acute myocardial infarction. Heart Vessels 31, 298–307 (2016). https://doi.org/10.1007/s00380-014-0610-8

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