scholarly journals Glycemic control and acute coronary syndrome: the debate continues

2015 ◽  
Vol 1 (4) ◽  
pp. 229-231 ◽  
Author(s):  
Raffaele Marfella ◽  
Giuseppe Paolisso
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Coronary Syndrome

Abstract 12188: Intensive Glycemic Control in Patients With Acute Coronary Syndrome: Evidence From a Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Partha Sardar ◽  
Ramez Nairooz ◽  
Saurav Chatterjee ◽  
Jacob A Udell ◽  
Dharam J Kumbhani ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Random Effect ◽  
Intensive Glucose Control ◽  
Intensive Glycemic Control ◽  
Coronary Syndrome ◽  
All Cause Mortality ◽  
Glucose Management ◽  
Management Groups

Introduction: Hyperglycemia is associated with unfavorable prognosis in patients with acute coronary syndrome (ACS). Studies with intensive glycemic control in ACS patients have provided inconsistent results. A meta-analysis was performed to evaluate the effectiveness and safety of intensive glycemic control in patients with ACS. Methods: Search of PubMed, Cochrane CENTRAL, EMBASE, EBSCO, Web of Science and CINAHL databases from their inception through April 2014, identifying randomized controlled trials (RCTs) comparing the effects of intensive versus standard glucose management in patients with ACS. We calculated summary random-effect odds ratios (OR) and 95% confidence intervals (CI). Results: Results from 10 RCTs comprising 2,621 patients were analyzed. All-cause mortality between intensive versus standard glucose management groups did not differ significantly (OR 1.00, 95% CI 0.75-1.34). Similarly, no significant differences were observed between the comparator groups for the odds of cardiac mortality (OR 0.87, 95% CI, 0.67 to 1.12), recurrent myocardial infarction (OR 1.07, 95% CI, 0.76 to 1.52), or stroke (OR 1.20, 95% CI, 0.60 to 2.40). The risk of hypoglycemia (OR 5.95, 95% CI, 2.73 to 12.97; p<0.001) was significantly higher with intensive compared with standard glucose management. Conclusions: Intensive glucose control compared with standard care in ACS patients did not reduce mortality or morbidity, but significantly increased the risk of hypoglycemia. These data from prior clinical trials should be interpreted in the context of their significant methodological limitations.

scholarly journals EFFECTS OF AN INTENSIVE GLYCEMIC CONTROL WITH INSULIN ON PLATELET REACTIVITY IN PATIENTS WITH ACUTE CORONARY SYNDROME: A LONG-TERM RESULTS OF THE CHIPS STUDY

2012 ◽  
Vol 59 (13) ◽  
pp. E529
Author(s):  
David Vivas ◽  
Esther Bernardo ◽  
Juan Carlos Garc&iacute;a-Rubira ◽  
Dominick Angiolillo ◽  
Patricia Mart&iacute;n ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Platelet Reactivity ◽  
Long Term Results ◽  
Intensive Glycemic Control ◽  
Coronary Syndrome

scholarly journals 1077-72 Assessment of glycemic control in patients with diabetes mellitus admitted with an acute coronary syndrome

2004 ◽  
Vol 43 (5) ◽  
pp. A406
Author(s):  
Darcy Green Conaway ◽  
David M Safley ◽  
Philip G Jones ◽  
Jonathan Enriquez ◽  
Michelle Stephan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Coronary Syndrome ◽  
Patients With Diabetes

scholarly journals The Impact of Glyco-Metabolic Status in Patients Treated for Acute Coronary Syndrome

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 37-50
Author(s):  
Marija Vavlukis ◽  
Biljana Zafirovska ◽  
Emilija Antova ◽  
Bekim Pocesta ◽  
Enes Shehu ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Morbidity And Mortality ◽  
Newly Diagnosed ◽  
Stress Hyperglycemia ◽  
Coronary Syndrome ◽  
Hospital Morbidity ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
The Impact

Abstract Objective: The aim of the study was to assess the prevalence of newly diagnosed diabetes in patients with acute coronary syndrome and estimate the relationship between stress hyperglycemia, glyco-regulation and newly diagnosed diabetes with hospital morbidity and mortality. Methods: This was an observational study which included all patients hospitalized due to acute coronary syndrome (January 2015 until April 2017) at the University Clinic of Cardiology in Skopje, Macedonia. We analyzed demographic, clinical, biochemical variables and hospital morbidity and mortality. Five investigated groups were compared using a single biochemical parameter glycated hemoglobin (HgbA1c) depending on the presence of known diabetes before the acute event: 0-without DM (HgbA1c <5.6%), 1-newly diagnosed pre-diabetes (HgbA1c 5.6-6.5%), 2-newly diagnosed diabetes (HgbA1c ≥ 6.5%), 3-known well controlled diabetes (HgbA1c <7%) and 4-known un-controlled diabetes (HgbA1c ≥7%). Results: 860 patients were analyzed. Impaired glucose metabolism was confirmed in 35% of patients, 9% of which were with newly diagnosed diabetes. Stress hyperglycemia was reported in 27.3% (3.6% were without diabetes). The highest values of stress hyperglycemia were reported in newly diagnosed and known un-controlled diabetes. In-hospital morbidity and mortality were 15% and 5% accordingly and the rate was highest in patients with newly diagnosed and known, but un-controlled diabetes. HgbA1c, stress hyperglycemia, and poor glycemic control have emerged as significant independent predictors of hospital morbidity and mortality in patients with acute coronary syndrome. Conclusion: High prevalence of newly diagnosed diabetes was observed in patients with acute coronary syndrome. Stress hyperglycemia and failure to achieve glycemic control are independent predictors of hospital morbidity and mortality.

Assessment of and physician response to glycemic control in diabetic patients presenting with an acute coronary syndrome

2006 ◽  
Vol 152 (6) ◽  
pp. 1022-1027 ◽  
Author(s):  
Darcy L. Green Conaway ◽  
Jonathan R. Enriquez ◽  
Jaime E. Barberena ◽  
Philip G. Jones ◽  
James H. O'Keefe ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Physician Response

scholarly journals Angiographic profile of coronary artery disease in patients with acute coronary syndrome in correlation to their glycaemic status

2021 ◽  
Vol 8 (6) ◽  
pp. 781
Author(s):  
Matin Parkar ◽  
Chandrakant Chavan ◽  
Shubhadarshini Pawar ◽  
Yugandhara Chavan
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Diabetes Control ◽  
Gensini Score ◽  
Duration Of Diabetes ◽  
Coronary Syndrome ◽  
Artery Disease

Background: Aim of the study was to study relationship between Glycemic control and presence of coronary artery disease on clinical presentation with acute coronary syndrome (ACS). We used blood sugar levels (Fasting and post prandial) and HbA1c as parameter for evaluation of glycemic control, Gensini score was used as a parameter for evaluation of severity of coronary artery disease.Methods: The analysis of 1200 patient’s data were performed to reveal demographic characteristics, correlation of the diabetes control with severity of the ACS. A sub-set of 200 subjects that was collected with a focus to include diabetic and non-diabetic subjects in proportion 1:2 was performed.Results: The Pearson correlation between HbA1c and Gensini score (r=0.0444) was poor the correlation between fasting blood sugar (FBS) and Gensini score (r=0.0586), and between post prandial blood sugar (PPBS) and Gensini score (r=0.0549), between random blood sugar (RBS) and Gensini score (r=0.0331) all indicative of poor correlation. Duration of diabetes and Gensini score revealed r=-0.039. The. Correlation was poor to moderate with one sided ANOVA and consistent on comparing r-sq values between, HbA1c and Gensini Score [rsq=49.62 (p<0.001)], FBS and Gensini score [rsq=32.19 (p<0.001)], PPBS and Gensini score [rsq=25.39 (<0.001)], RBS and Gensini score [rsq=42.49 (p<0.001)] and duration of diabetes and Gensini score [rsq=19.61 (p<0.001)].Conclusions: There was no correlation evident between diabetes and Gensini dcore. The analysis was suggestive of possible strong relationship between diabetes control and IHD severity. There is no correlation between Diabetes and ACS severity. However, better diabetes control is related with better ACS profile.

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