Glycemic Variability Determined by Continuous Glucose Monitoring System Predicts Left Ventricular Remodeling in Patients With a First ST-Segment Elevation Myocardial Infarction

Circulation Journal : Official Journal of the Japanese Circulation Society
Masaomi GohbaraKazuo Kimura

Abstract

Impaired glucose metabolism plays an important role in patients with acute myocardial infarction, but the clinical significance of glycemic variability (GV) early after the onset of ST-segment elevation myocardial infarction (STEMI) remains to be fully elucidated. We prospectively investigated the clinical impact of GV, as determined by a continuous glucose monitoring system (CGMS), on left ventricular remodeling (LVR) assessed by cardiac magnetic resonance imaging (CMR) in 69 patients (63±13 years, 59 men) with a first reperfused STEMI within 12 h of onset. All patients were equipped with a CGMS when in a stable phase after admission and underwent repeat CMR at baseline and 7 months follow-up. Patients were divided into 2 groups according to the mean amplitude of glycemic excursions (MAGE). Patients in the upper tertile of MAGE were categorized as group High (H) and the other two-thirds as group Low (L). LVR was defined as an absolute increase in left ventricular end-diastolic volume index of ≥20%. LVR more frequently occurred in group H than in group L (56% vs. 11%, P<0.001). Multivariate analysis showed the higher MAGE group was an independent predictor of LVR in the chronic phase (odds ratio, 13.999; 95% confidence interval,...Continue Reading

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Citations

Feb 3, 2016·Diabetes Technology & Therapeutics·Tadej Battelino, Bruce W Bode
Aug 1, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Shunsuke KataokaKazuo Kimura
Sep 4, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroshi Asanuma, Masafumi Kitakaze
Apr 14, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahiro Natsuaki, Koichi Node
Jun 23, 2020·The Journal of International Medical Research·Maria Isabel Del Olmo-GarcíaJuan Francisco Merino-Torres
Oct 12, 2021·BMC Cardiovascular Disorders·Machiko MiyoshiHiroshi Tada

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