Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
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 GohbaraNoriaki IwahashiShunsuke KataokaYoshikazu HayakawaKentaro SakamakiEiichi AkiyamaNobuhiko MaejimaKengo TsukaharaKiyoshi HibiMasami KosugeToshiaki EbinaSatoshi UmemuraKazuo Kimura
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2015 Volume 79 Issue 5 Pages 1092-1099

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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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© 2015 THE JAPANESE CIRCULATION SOCIETY
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