Does Tight Glucose Control Prevent Myocardial Injury and Inflammation?

Hyperglycemia has been postulated to be cardiotoxic. We addressed the hypothesis that uncontrolled blood glucose induces myocardial damage in diabetic patients undergoing isolated coronary artery bypass graft surgery receiving continuous insulin infusion in the immediate postoperative period. Our pr...

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Bibliographic Details
Published in:The Journal of extra-corporeal technology 2011-09, Vol.43 (3), p.144-152
Main Authors: BROWN, Jeremiah R, FURNARY, Anthony P, MACKENZIE, Todd A, DUQUETTE, Dennis, HELM, Robert E, PALIOTTA, Marco, ROSS, Cathy S, MALENKA, David J, O'CONNOR, Gerald T
Format: Article
Language:English
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Abstract
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Glucose - metabolism
C-Reactive Protein - analysis
Cardiology. Vascular system
Coronary Artery Bypass - adverse effects
Diabetes Mellitus - blood
Diabetes Mellitus - drug therapy
Female
Glycated Hemoglobin A - analysis
Heart
Humans
Inflammation
Insulin
Insulin Infusion Systems
Male
Medical sciences
Myocarditis. Cardiomyopathies
Myocardium - metabolism
Myocardium - pathology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Troponin I - metabolism
Tumor Necrosis Factor-alpha - blood
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Summary:Hyperglycemia has been postulated to be cardiotoxic. We addressed the hypothesis that uncontrolled blood glucose induces myocardial damage in diabetic patients undergoing isolated coronary artery bypass graft surgery receiving continuous insulin infusion in the immediate postoperative period. Our primary aim was to assess the degree of tight glycemic control for each patient and to link the degree of glycemic control to intermediate outcome of myocardial damage. We prospectively enrolled 199 consecutive patients with diabetes undergoing isolated coronary artery bypass graft surgery from October 2003 through August 2005. Preoperative hemoglobin A1c and glucose measures were collected from the surgical admission. We measured biomarkers of myocardial damage (cardiac troponin I) and metabolic dysfunction (blood glucose and hemoglobin A1c) to identify a difference among patients under tight (90-100% of glucose measures < or = 150 mg/dL) or loose (
ISSN:0022-1058
2969-8960
DOI:10.1051/ject/201143144