Management of blood glucose in patients with acute coronary syndromes

Rev Cardiovasc Med. 2012;13(2-3):e77-88. doi: 10.3909/ricm0615.

Abstract

Hyperglycemia during admission for acute myocardial infarction (MI) is common and associated with poor outcomes. Prior studies employed two distinct approaches to improve outcomes in patients with acute MI--one focused on glucose control, and the other on provision of glucose, insulin, and potassium. However, despite multiple largescale studies, the benefits of glucose lowering in the setting of acute MI remain unclear. This article reviews data from observational studies and clinical trials and synthesizes this information into practical recommendations based on available evidence.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / drug therapy*
  • Acute Coronary Syndrome / mortality
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Cardioplegic Solutions / adverse effects
  • Cardioplegic Solutions / therapeutic use*
  • Glucose / adverse effects
  • Glucose / therapeutic use
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / drug therapy*
  • Hyperglycemia / mortality
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / adverse effects
  • Insulin / therapeutic use
  • Myocardial Infarction / blood
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / mortality
  • Patient Admission
  • Patient Selection
  • Potassium / adverse effects
  • Potassium / therapeutic use
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Blood Glucose
  • Cardioplegic Solutions
  • Hypoglycemic Agents
  • Insulin
  • glucose-insulin-potassium cardioplegic solution
  • Glucose
  • Potassium