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Early glucose variability in cardiogenic shock following acute myocardial infarction: a pilot study

Chiara Lazzeri1, Serafina Valente2, Marco Chiostri2

  • 1Intensive Cardiac Care Unit, Heart and Vessel Department, Viale Morgagni 85, 50134 Florence, Italy lazzeric@libero.it.

Therapeutic Advances in Cardiovascular Disease
|March 27, 2015
PubMed

Insights

Early high glucose variability in ST-elevation myocardial infarction patients with cardiogenic shock predicts mortality. Lower variability in survivors suggests a potential therapeutic target for improving outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Intensive Care Medicine

Background:

  • Limited data exists on the link between glucose variability and outcomes in ST-elevation myocardial infarction (STEMI) patients experiencing cardiogenic shock (CS).
  • Understanding this association is crucial for identifying prognostic markers and potential interventions.

Purpose of the Study:

  • To investigate the relationship between early glycaemic variability and mortality in patients with CS post-STEMI.
  • To determine if glycaemic variability metrics are independent predictors of short-term and long-term mortality.

Main Methods:

  • A cohort of 67 consecutive CS post-STEMI patients was studied.
  • Glycaemic variability was assessed within the first 48 hours using standard deviation (SD) of glucose and mean absolute glucose change per hour (MAGC).

Main Results:

  • Survivors exhibited significantly lower glycaemic variability (lower SD and MAGC) compared to non-survivors.
  • Both MAGC and SD were identified as independent predictors of mortality (p=0.002 and p=0.003, respectively).
  • Peak glycaemia also emerged as an independent predictor of death (adjusted HR: 1.95, p=0.007).

Conclusions:

  • Early glycaemic variability serves as an independent predictor of mortality in CS patients following acute myocardial infarction.
  • Further research in larger cohorts is warranted to validate these findings.
  • Investigating strategies to reduce glucose variability may offer a novel therapeutic approach to improve patient outcomes.
Abstract

Keywords:
ST elevation myocardial infarctioncardiogenic shockglucose valuesglycaemic variabilitymortality

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