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Heart 2009;95:697-703 doi:10.1136/hrt.2008.146027
  • Review

Hyperglycaemia in acute coronary syndromes: risk-marker or therapeutic target?

  1. R Anantharaman1,
  2. M Heatley1,
  3. C F M Weston2
  1. 1
    Department of Cardiology, Swansea NHS Trust, Swansea, UK
  2. 2
    School of Medicine, Swansea University, Swansea, UK
  1. Dr C F M Weston, Department of Cardiology, Swansea NHS Trust, Swansea SA2 8QA, UK; C.F.M.Weston{at}swansea.ac.uk
  • Accepted 15 July 2008
  • Published Online First 12 August 2008

Abstract

Patients with acute coronary syndrome (ACS) often have raised blood glucose concentrations when admitted to hospital; a marker for poorer prognosis. Interventions to rapidly normalise blood glucose inconsistently are applied and with uncertain utility. Here we review the association of hyperglycaemia with outcome, present evidence that this hyperglycaemia reflects more than a pre-existing diabetic state and discuss mechanisms by which glucose may adversely affect the course of acute myocardial infarction (AMI). Finally, we seek evidence that intensive insulin treatment improves outcome.

Footnotes

  • Funding: None.

  • Competing interests: None.

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