GLUCOSE METABOLISM DISTURBANCES IN ACUTE MYOCARDIAL INFARCTION

Abstract

The enormous impact that diabetes mellitus has on health systems worldwide is especially determined by a greater prevalence of coronary heart disease, an increased incidence of acute coronary syndromes and a worse prognostic during the recovery phase after an acute coronary event, by comparison to non-diabetic population. Hyperglycemia is a frequent finding in patients admitted with acute myocardial infarction (AMI) and carries an increased risk of mortality, in both known diabetics and patients not previously diagnosed with diabetes. The risk excess is evident even in the “pre-diabetic” states, characterized by disregulation of glucose metabolism (like impaired glucose tolerance). The stimulation of inflammatory processes in AMI seems to be the link between acute hyperglycemia and worse outcome. Recent data has shown that insulin has an anti-inflammatory effect on a cellular level. Clinical research has proved that aggressive glycemic control improves prognosis in AMI. The means of achieving tight glucose control are more controversial.