Persistent Hyperglycemia is Associated With Left Ventricular Dysfunction in Patients With Acute Myocardial Infarction

概要

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Background The relationship of changes in blood glucose concentrations after admission to left ventricular (LV) dysfunction in patients with recanalized anterior acute myocardial infarction (AMI) remains unclear. Methods and Results Blood glucose concentrations were measured on admission and 24 h after symptom onset in 210 patients with recanalized anterior AMI within 6h of symptom onset. Of them, 142 had hyperglycemia on admission, defined as a blood glucose ≥8.9mmol/L, and 68 patients did not. Among the patients with admission hyperglycemia, 49 had persistent hyperglycemia, defined as a blood glucose ≥8.9mmol/L 24h after onset, and 93 did not. The incidences of myocardial blush grade of 0/1 after recanalization indicating impaired myocardial perfusion (71%), and peak creatine kmase concentration (5,631±2,855mU/ml) were higher and predischarge LV function (43±11%) was lower in patients with persistent hyperglycemia than in those without (p<0.01). Multivariate analysis showed that persistent hyperglycemia was independently associated with LV dysfunction, defined as a predischarge LV ejection fraction ≤0% (odds ratio 7.38, p=0.001). Conclusions Persistent hyperglycemia at 24 h after symptom onset is associated with LV dysfunction before discharge in patients with recanalized anterior AMI.
社団法人日本循環器学会の論文
2004-12-20