Abstract
Though age is a predictor of adverse events after acute coronary syndrome, including in-hospital and posthospital mortality rates, elderly patients are under-represented in randomized trials evaluating strategies of early coronary revascularization in acute myocardial infarction. Several factors can account for the unfavorable outcome of the elderly, comprising increased glucose values. Diabetes is more common in the elderly patients with acute myocardial infarction in respect to younger patients and elevated glucose, though common, are rarely treated and associated with increased mortality, particularly in those without recognized diabetes. Age itself is thought to affect the acute glucose response to stress. Human aging is associated with impaired β-cell sensitivity to glucose and impaired β-cell compensation to insulin resistance and older people exhibit an impaired glucose response after injury characterized by a more marked increases in endogenous glucose production. In the early phase of ST elevation myocardial infarction (STEMI), the acute glucose response to stress comprises not only hyperglycemia but also insulin-resistance (assessed by the Homeostatic Model Assessment). Recently it has been documented in 346 STEMI patients submitted to mechanical revascularization that the acute glucose response to myocardial injury differs in respect to age, since older patients showed the highest glucose levels and the poorest glycemic control during ICCU stay in the lack of differences in insulin resistance incidence. Taking into account that aging impairs the acute glucose response to stress in elderly STEMI patients, further studies are needed to establish whether a different (more aggressive) therapeutic regime is needed in this subgroup of patients at higher risk.
| Original language | English |
|---|---|
| Pages (from-to) | 66-69 |
| Number of pages | 4 |
| Journal | International Journal of Cardiology |
| Volume | 155 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 23 2012 |
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Keywords
- Acute glucose dysmetabolism
- Acute insulin resistance
- Hyperglycemia
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Acute glucose dysmetabolism in the elderly with ST elevation myocardial infarction submitted to mechanical revascularization. / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Picariello, Claudio; Gensini, Gian Franco.
In: International Journal of Cardiology, Vol. 155, No. 1, 23.02.2012, p. 66-69.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute glucose dysmetabolism in the elderly with ST elevation myocardial infarction submitted to mechanical revascularization
AU - Lazzeri, Chiara
AU - Valente, Serafina
AU - Chiostri, Marco
AU - Picariello, Claudio
AU - Gensini, Gian Franco
PY - 2012/2/23
Y1 - 2012/2/23
N2 - Though age is a predictor of adverse events after acute coronary syndrome, including in-hospital and posthospital mortality rates, elderly patients are under-represented in randomized trials evaluating strategies of early coronary revascularization in acute myocardial infarction. Several factors can account for the unfavorable outcome of the elderly, comprising increased glucose values. Diabetes is more common in the elderly patients with acute myocardial infarction in respect to younger patients and elevated glucose, though common, are rarely treated and associated with increased mortality, particularly in those without recognized diabetes. Age itself is thought to affect the acute glucose response to stress. Human aging is associated with impaired β-cell sensitivity to glucose and impaired β-cell compensation to insulin resistance and older people exhibit an impaired glucose response after injury characterized by a more marked increases in endogenous glucose production. In the early phase of ST elevation myocardial infarction (STEMI), the acute glucose response to stress comprises not only hyperglycemia but also insulin-resistance (assessed by the Homeostatic Model Assessment). Recently it has been documented in 346 STEMI patients submitted to mechanical revascularization that the acute glucose response to myocardial injury differs in respect to age, since older patients showed the highest glucose levels and the poorest glycemic control during ICCU stay in the lack of differences in insulin resistance incidence. Taking into account that aging impairs the acute glucose response to stress in elderly STEMI patients, further studies are needed to establish whether a different (more aggressive) therapeutic regime is needed in this subgroup of patients at higher risk.
AB - Though age is a predictor of adverse events after acute coronary syndrome, including in-hospital and posthospital mortality rates, elderly patients are under-represented in randomized trials evaluating strategies of early coronary revascularization in acute myocardial infarction. Several factors can account for the unfavorable outcome of the elderly, comprising increased glucose values. Diabetes is more common in the elderly patients with acute myocardial infarction in respect to younger patients and elevated glucose, though common, are rarely treated and associated with increased mortality, particularly in those without recognized diabetes. Age itself is thought to affect the acute glucose response to stress. Human aging is associated with impaired β-cell sensitivity to glucose and impaired β-cell compensation to insulin resistance and older people exhibit an impaired glucose response after injury characterized by a more marked increases in endogenous glucose production. In the early phase of ST elevation myocardial infarction (STEMI), the acute glucose response to stress comprises not only hyperglycemia but also insulin-resistance (assessed by the Homeostatic Model Assessment). Recently it has been documented in 346 STEMI patients submitted to mechanical revascularization that the acute glucose response to myocardial injury differs in respect to age, since older patients showed the highest glucose levels and the poorest glycemic control during ICCU stay in the lack of differences in insulin resistance incidence. Taking into account that aging impairs the acute glucose response to stress in elderly STEMI patients, further studies are needed to establish whether a different (more aggressive) therapeutic regime is needed in this subgroup of patients at higher risk.
KW - Acute glucose dysmetabolism
KW - Acute insulin resistance
KW - Hyperglycemia
UR - http://www.scopus.com/inward/record.url?scp=84859911688&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84859911688&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2011.01.075
DO - 10.1016/j.ijcard.2011.01.075
M3 - Article
C2 - 21345499
AN - SCOPUS:84859911688
VL - 155
SP - 66
EP - 69
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 1
ER -