Does Tight Glucose Control During the First 24 hours of Hospitalization Reduce Scintigraphic Infarct Size in STEMI Patients?
| Autor: | Murat Başkurt, Kamil Gulsen, Murat Ersanli, Burak Ayça, Barış Ökçün |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 02 engineering and technology ST-Elevation Myocardial Infarction/mortality/mortality Insulin infusion Myocardial perfusion imaging Internal medicine 0202 electrical engineering electronic engineering information engineering Medicine Insulin Tight glucose control Myocardial infarction cardiovascular diseases medicine.diagnostic_test business.industry Tomography Emission Computed Single Photon/methods Myocardial Perfusion Imaging 020206 networking & telecommunications medicine.disease Infarct size Hospitalization surgical procedures operative Hyperglycemia Cardiology Coronary care unit Population study 020201 artificial intelligence & image processing business |
| Zdroj: | International Journal of Cardiovascular Sciences, Volume: 33, Issue: 5, Pages: 497-505, Published: 07 AUG 2020 International Journal of Cardiovascular Sciences, Issue: ahead, Published: 07 AUG 2020 International Journal of Cardiovascular Sciences v.33 n.5 2020 International Journal of Cardiovascular Sciences Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
| Popis: | Background Hyperglycemia at the time of admission is related to increased mortality and poor prognosis in patients diagnosed with ST-segment elevation myocardial infarction (STEMI). Objective We aimed to investigate whether tight glucose control during the first 24 hours of STEMI decreases the scintigraphic infarct size. Methods The study population consisted of 56 out of 134 consecutive patients hospitalized with STEMI in a coronary care unit. Twenty-eight patients were treated with continuous insulin infusion during the first 24 hours of hospitalization, while the other 28 patients were treated with subcutaneous insulin on an as-needed basis. The final infarct size was evaluated with single-photon emission computed tomography (SPECT) in all patients on days 4 to 10 of hospitalization. The groups were compared and then predictors of final infarct size were analyzed with univariate and multivariate linear regression analysis. A p-value < 0.05 was considered statistically significant. Results The mean glucose level in the first 24 hours was 130 ± 20 mg/dL in the infusion group and 152 ± 31 mg/dL in the standard care group (p = 0.002), while the mean final infarct size was 20 ± 12% and 27 ± 15% (p = 0.06), respectively. The multivariate linear regression analysis demonstrated that the mean 24-hour glucose level was an independent predictor of the final infarct size (beta 0.29, p = 0.026). Conclusion Tight glucose control with continuous insulin infusion was not associated with smaller infarct size when compared to standard care in STEMI patients. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0) |
| Databáze: | OpenAIRE |
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