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

Masaomi Gohbara; Noriaki Iwahashi; Shunsuke Kataoka; Yoshikazu Hayakawa; Kentaro Sakamaki; Eiichi Akiyama; Nobuhiko Maejima; Kengo Tsukahara; Kiyoshi Hibi; Masami Kosuge; Toshiaki Ebina; Satoshi Umemura; Kazuo Kimura

doi:10.1253/circj.CJ-14-1226

Metabolic Disorder

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

Masaomi Gohbara, Noriaki Iwahashi, Shunsuke Kataoka, Yoshikazu Hayakawa, Kentaro Sakamaki, Eiichi Akiyama, Nobuhiko Maejima, Kengo Tsukahara, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

Author information

Masaomi Gohbara
Division of Cardiology, Yokohama City University Medical Center
Noriaki Iwahashi
Division of Cardiology, Yokohama City University Medical Center
Shunsuke Kataoka
Division of Cardiology, Yokohama City University Medical Center
Yoshikazu Hayakawa
Division of Radiology, Yokohama City University Medical Center
Kentaro Sakamaki
Department of Biostatistics and Epidemiology, Yokohama City University Medical Center
Eiichi Akiyama
Division of Cardiology, Yokohama City University Medical Center
Nobuhiko Maejima
Division of Cardiology, Yokohama City University Medical Center
Kengo Tsukahara
Division of Cardiology, Yokohama City University Medical Center
Kiyoshi Hibi
Division of Cardiology, Yokohama City University Medical Center
Masami Kosuge
Division of Cardiology, Yokohama City University Medical Center
Toshiaki Ebina
Division of Cardiology, Yokohama City University Medical Center
Satoshi Umemura
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
Kazuo Kimura
Division of Cardiology, Yokohama City University Medical Center

Keywords: Acute myocardial infarction, Continuous glucose monitoring system, Glucose, Glycemic variability, Remodeling

JOURNAL FREE ACCESS FULL-TEXT HTML

2015 Volume 79 Issue 5 Pages 1092-1099

DOI https://doi.org/10.1253/circj.CJ-14-1226

Editorial (79-5 pp. 972-973)

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Abstract

Background: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.Methods and Results: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, 3.059 to 64.056; P=0.001).Conclusions:MAGE early after the onset of STEMI identified patients with LVR in the chronic phase. (Circ J 2015; 79: 1092–1099)

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