Abstract
We evaluated the relationship between admission renal function (as assessed by estimated glomerular filtration rate (eGFR)), hyperglycemia, and acute insulin resistance, indicated by the homeostatic model assessment (HOMA) index, and their impact on long-term prognosis in 825 consecutive patients with ST-elevation myocardial infarction (STEMI) without previously known diabetes who underwent primary percutaneous coronary intervention (PCI). Admission eGFR showed a significant indirect correlation with admission glycemia (Spearman’s ρ −0.23, P <0.001) and insulin values (Spearman’s ρ −0.11, P = 0.002). The incidence of patients with admission glycemia ≥140 mg/dl was significantly higher in patients with eGFR 2 (P <0.001) as well as the incidence of HOMA positivity (P = 0.002). According to our data, a relationship between renal function and glucose values and acute insulin resistance in the early phase of STEMI was detectable, since a significant, indirect correlation between eGFR, insulin values, and glycemia was observed. Patients with renal dysfunction (eGFR 2) exhibited higher glucose values and a higher incidence of acute insulin resistance (as assessed by HOMA index) than those with normal renal function (eGFR ≥60 ml/min/1.73 m2). The prognostic role of glucose values for 1-year mortality was confined to patients with eGFR ≥60 ml/min/m2, who represent the large part of our population and are thought to be at lower risk. In these patients, an independent relationship between 1-year mortality and glucose values was detectable not only for admission glycemia but also for glucose values measured at discharge.
| Original language | English |
|---|---|
| Pages (from-to) | 769-775 |
| Number of pages | 7 |
| Journal | Heart and Vessels |
| Volume | 29 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Nov 1 2014 |
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Keywords
- Acute insulin resistance (HOMA index)
- Hyperglycemia
- Long-term prognosis
- Renal dysfunction
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Hyperglycemia, acute insulin resistance, and renal dysfunction in the early phase of ST-elevation myocardial infarction without previously known diabetes : impact on long-term prognosis. / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Attanà, Paola; Mattesini, Alessio; Nesti, Martina; Gensini, Gian Franco.
In: Heart and Vessels, Vol. 29, No. 6, 01.11.2014, p. 769-775.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hyperglycemia, acute insulin resistance, and renal dysfunction in the early phase of ST-elevation myocardial infarction without previously known diabetes
T2 - impact on long-term prognosis
AU - Lazzeri, Chiara
AU - Valente, Serafina
AU - Chiostri, Marco
AU - Attanà, Paola
AU - Mattesini, Alessio
AU - Nesti, Martina
AU - Gensini, Gian Franco
PY - 2014/11/1
Y1 - 2014/11/1
N2 - We evaluated the relationship between admission renal function (as assessed by estimated glomerular filtration rate (eGFR)), hyperglycemia, and acute insulin resistance, indicated by the homeostatic model assessment (HOMA) index, and their impact on long-term prognosis in 825 consecutive patients with ST-elevation myocardial infarction (STEMI) without previously known diabetes who underwent primary percutaneous coronary intervention (PCI). Admission eGFR showed a significant indirect correlation with admission glycemia (Spearman’s ρ −0.23, P <0.001) and insulin values (Spearman’s ρ −0.11, P = 0.002). The incidence of patients with admission glycemia ≥140 mg/dl was significantly higher in patients with eGFR 2 (P <0.001) as well as the incidence of HOMA positivity (P = 0.002). According to our data, a relationship between renal function and glucose values and acute insulin resistance in the early phase of STEMI was detectable, since a significant, indirect correlation between eGFR, insulin values, and glycemia was observed. Patients with renal dysfunction (eGFR 2) exhibited higher glucose values and a higher incidence of acute insulin resistance (as assessed by HOMA index) than those with normal renal function (eGFR ≥60 ml/min/1.73 m2). The prognostic role of glucose values for 1-year mortality was confined to patients with eGFR ≥60 ml/min/m2, who represent the large part of our population and are thought to be at lower risk. In these patients, an independent relationship between 1-year mortality and glucose values was detectable not only for admission glycemia but also for glucose values measured at discharge.
AB - We evaluated the relationship between admission renal function (as assessed by estimated glomerular filtration rate (eGFR)), hyperglycemia, and acute insulin resistance, indicated by the homeostatic model assessment (HOMA) index, and their impact on long-term prognosis in 825 consecutive patients with ST-elevation myocardial infarction (STEMI) without previously known diabetes who underwent primary percutaneous coronary intervention (PCI). Admission eGFR showed a significant indirect correlation with admission glycemia (Spearman’s ρ −0.23, P <0.001) and insulin values (Spearman’s ρ −0.11, P = 0.002). The incidence of patients with admission glycemia ≥140 mg/dl was significantly higher in patients with eGFR 2 (P <0.001) as well as the incidence of HOMA positivity (P = 0.002). According to our data, a relationship between renal function and glucose values and acute insulin resistance in the early phase of STEMI was detectable, since a significant, indirect correlation between eGFR, insulin values, and glycemia was observed. Patients with renal dysfunction (eGFR 2) exhibited higher glucose values and a higher incidence of acute insulin resistance (as assessed by HOMA index) than those with normal renal function (eGFR ≥60 ml/min/1.73 m2). The prognostic role of glucose values for 1-year mortality was confined to patients with eGFR ≥60 ml/min/m2, who represent the large part of our population and are thought to be at lower risk. In these patients, an independent relationship between 1-year mortality and glucose values was detectable not only for admission glycemia but also for glucose values measured at discharge.
KW - Acute insulin resistance (HOMA index)
KW - Hyperglycemia
KW - Long-term prognosis
KW - Renal dysfunction
UR - http://www.scopus.com/inward/record.url?scp=84923324642&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923324642&partnerID=8YFLogxK
U2 - 10.1007/s00380-013-0429-8
DO - 10.1007/s00380-013-0429-8
M3 - Article
C2 - 24142067
AN - SCOPUS:84923324642
VL - 29
SP - 769
EP - 775
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 6
ER -