The influence of insulin therapy on the short-term prognosis of patients with acute ST-elevation myocardial infarction complicated with hyperglycaemia
DING Huai-yu, LIU Jun, ZHOU Xu-chen, ZHU Hao
Published 2012-01-01
Cite as , 2012,28(01): 19-21. DOI: 10.3760/cma.j.issn.1008-6315.2012.007
Abstract
Objective To observe the influence of insulin therapy on the short-term prognosis of patients with acute ST-elevation myocardial infarction (ASTEMI) complicated with hyperglycaemia.Methods A total of 128 patients with ASTEMI complicated with hyperglycaemia were randomized into 2 groups:treatment group and control group.There were 64 patients(50.0% )in the treatment group and 64 patients(50.0% ) in the control group.All of the patients were given anticoagulants,antiplatelet drugs,statins,beta-receptor blockers,nitrates and angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB) Moreover,the patients in the treatment group were given extra 50 U insulin ( Novolin R) in 50 ml saline by venous infusion.In the treatment group,Venous blood samples were obtained before and 7 days after treatment to determine the fasting blood glucose and hs-CRP in serum; the levels of fasting blood glucose and hs-CRP and short-term prognosis were compared between the 2 groups.Results The levels of fasting blood glucose in the treatment group were decreased significantly after treatment ( [ 5.4 ± 0.8 ] mmol/L vs [ 11.6 ± 2.3 ] mmol/L,P <0.01),but there was no significant change in the control group( [ 10.7 ± 2.1 ] mmol/L vs [ 11.2 ± 2.7]mmol/L,P > 0.05 ).The levels of hs-CRP in both groups were decreased significantly after treatment (P <0.05),but it was much more obvious in the treatment group( [ 6.2 ± 1.5 ] mg/L vs [ 8.7 ± 1.8 ] mg/L,P <0.05).The incidence of major adverse cardiac events(MACE) during a 3 months′ follow-up in the treatment group was significantly lower than that in the control group ( 12.50% vs 34.38%,P < 0.05 ).Conclusion Insulin therapy can improve the short-term prognosis in patients with ASTEMI complicated with hyperglycaemia.
Key words:
Myocardial infarction; Stress-induced hyperglycaemia; C reactive protein; Major adverse cardiac events
Contributor Information
DING Huai-yu
Department of Cardiology, the First Hospital Affiliated to Dalian Medical University ,Dalian116011, China
LIU Jun
Department of Cardiology, the First Hospital Affiliated to Dalian Medical University ,Dalian116011, China
ZHOU Xu-chen
Department of Cardiology, the First Hospital Affiliated to Dalian Medical University ,Dalian116011, China
ZHU Hao
Department of Cardiology, the First Hospital Affiliated to Dalian Medical University ,Dalian116011, China