Title: Prognostic Value of Acute Hyperglycaemia in Non-Diabetic Acute Myocardial Infarction Patients
Authors: Dr Nishant Sunakarineni, Dr Veena Ramachandran
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.55
Abstract
In recent years, much attention has been given to the evidence that the concomitant occurrence of hyperglycaemia in patients admitted to intensive care units with an acute myocardial infarction (AMI) enhances the risk of mortality and morbidity, whether the patient was diagnosed with having diabetes or not.1 In some cases, the elevation of glucose levels could simply be a marker of pre-existing, but not yet detected, type 2 diabetes or impaired glucose tolerance (IGT).2 This may mean that besides being causal, elevated glucose also could be a marker of existing insulin resistance and/or beta-cell failure that may contribute to the poor prognosis through other mechanisms. However, a positive association between hyperglycaemia at the time of the event and subsequent mortality from AMI has frequently been reported.3,4,5,6 A strong correlation between glycaemia and shock or development of heart failure has also been reported.7 Consequently, understanding the possible mechanisms through which hyperglycaemia worsens the prognosis of AMI, as well the effectiveness of its control during AMI, seems to be of great relevance.
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