Lowering glucose to prevent adverse cardiovascular outcomes in a critical care setting

J Am Coll Cardiol. 2009 Feb 3;53(5 Suppl):S9-13. doi: 10.1016/j.jacc.2008.09.054.

Abstract

High admission blood glucose levels after acute myocardial infarction are common and associated with an increased risk of death in patients with or without diabetes. Hyperglycemia is associated with altered myocardial blood flow and energetics and can lead to a pro-oxidative/proinflammatory state. The use of intensive insulin treatment has shown superior benefits in the treatment of hyperglycemia versus glucose-insulin-potassium infusion, particularly in critical care settings.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / physiopathology
  • Algorithms
  • Blood Glucose / drug effects*
  • Critical Care*
  • Glucose Intolerance / prevention & control
  • Glucose Tolerance Test
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / prevention & control*
  • Hypoglycemic Agents / therapeutic use*
  • Inflammation
  • Insulin / therapeutic use*
  • Myocardial Infarction / blood
  • Myocardial Infarction / complications*
  • Myocardial Infarction / physiopathology
  • Oxidative Stress
  • Prognosis
  • Risk Factors
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin