[Role of blood glucose in prediction of cardiovascular risk]

Increased cardiovascular risk in diabetes mellitus has been well-documented. In contrast, it is not widely known, that the relation between degree of hyperglycemia and mortality of diabetics or nondiabetics with acute coronary syndromes (ACS) shows a positive correlation. Insulin treatment significantly improves survival of patients with both ACS and septicemia. New onset diabetes or impaired glucose tolerance can be detected in significant proportion of patients with AMI or coronary artery disease. New onset disturbance of carbohydrate metabolism has a powerful negative influence on clinical prognosis, therefore it's early diagnosis is considered an important new challenge for clinicians. The authors discuss prognostic significance of hyperglycemia-induced macroangiopathy, postprandial blood glucose, and concomitant metabolic state, respectively, furthermore potential therapeutic role of insulin in treatment of ischemic, reperfusional, and toxic metabolic disturbances.