A multicenter observational study on the management of hyperglycemia in patients with acute coronary syndrome
| Autor: | Avanzini, F, Mafrici, A, Riva, E, Franzosi, MG, Milani, V, Giudici, V, Marelli, G, Mariani, G, Piatti, PM, Roncaglioni, MC, on behalf of GLICINE-SPIDER Collaborative Group, Margonato, A, Cianflone, D |
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| Přispěvatelé: | Avanzini, F, Mafrici, A, Riva, E, Franzosi, Mg, Milani, V, Giudici, V, Marelli, G, Mariani, G, Piatti, Pm, Roncaglioni, Mc, on behalf of GLICINE-SPIDER Collaborative, Group, Margonato, A, Cianflone, D |
| Rok vydání: | 2015 |
| Předmět: |
Blood Glucose
Male Diabetes mellitu Poor prognosis Acute coronary syndrome medicine.medical_specialty Prognosi Endocrinology Diabetes and Metabolism medicine.medical_treatment Medicine (miscellaneous) Diabetes Complications Diabetes Complication Diabetes mellitus Internal medicine Diabetes Mellitus Nutrition and Dietetic Humans Insulin Medicine In patient Prospective Studies Acute Coronary Syndrome Prospective cohort study Intensive care medicine Coronary Care Unit Aged Nutrition and Dietetics business.industry Incidence (epidemiology) Coronary Care Units Intensive cardiac care unit Middle Aged Prognosis medicine.disease Prospective Studie Treatment Outcome Italy Hyperglycemia Female Observational study Cardiology and Cardiovascular Medicine business Human |
| Zdroj: | Nutrition, Metabolism and Cardiovascular Diseases. 25:916-923 |
| ISSN: | 0939-4753 |
| DOI: | 10.1016/j.numecd.2015.07.007 |
| Popis: | Aim To assess the prevalence, risk and management of hyperglycemia in patients with acute coronary syndrome (ACS). Methods and Results Design: a multicenter prospective observational study of a representative sample of patients with ACS consecutively admitted to intensive cardiac care units (ICCU). Setting: 31 out of 61 ICCUs in Lombardy, the most heavily populated Italian region. From May 2009 to April 2010 1260 patients (69.4% male; mean age 68 ± 13 years) were included in the study: 301 (23.9%) were known diabetic patients (D) and 265 (21.0%) had hyperglycemia (H) (blood glucose >180 mg/dL) at hospital admission, 174 with a history of diabetes (D+H+) and 91 without (D−H+). On the first day after admission intravenous insulin infusion was prescribed to 72 D+H+ (41.4%) and 10 D−H+ (11.0%), according to different protocols. Approximately one third of D+H+ patients (59) and one fifth (17) of D−H+ maintained mean blood glucose higher than 180 mg/dL during the first day in the ICCU. Patients with diabetes or hyperglycemia had a higher incidence of major adverse cardiovascular events or death in hospital. However, at multivariable analysis neither diabetes nor blood glucose at admission was associated with a poor prognosis whereas mean blood glucose on the first day was an independent negative prognostic predictor (OR 1.010, 95% CI 1.002–1.018, p = 0.016). Conclusion Hyperglycemia is frequent in patients with ACS and is independently associated with a poor in-hospital prognosis if it persists in first day. Unfortunately, however, this condition is still poorly treated, with far from optimal blood glucose control. |
| Databáze: | OpenAIRE |
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