European Heart Journal Advance Access originally published online on October 24, 2007
European Heart Journal 2007 28(22):2821-2822; doi:10.1093/eurheartj/ehm459
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Is stress hyperglycaemia a prognostic marker of left ventricular remodelling after first anterior myocardial infarction?: reply
Centre Hospitalier Régional et Universitaire de Lille Lille, France
Faculté de Médecine de Lille Lille, France
Hôpital Cardiologique CHRU de Lille Boul. Prof. Leclercq
59037 Lille Cedex
France
Tel: +33 320445045 Fax: +33 320444881 E-mail address: cbauters{at}chru-lille.fr
We thank Papadopoulos et al. for their interest in our manuscript. Their findings that stress hyperglycaemia was associated with left ventricular remodelling after anterior myocardial infarction (r = 0.471; P = 0.004) is indeed concordant with our results.1 The covariates that were available for inclusion into the multivariate models however differed and brain natriuretic peptide (BNP) levels were not routinely obtained in the REVE study.2 The demonstration that BNP plasma levels were significantly higher in patients with stress hyperglycaemia and that stress hyperglycaemia was not an independent predictor of left ventricular remodelling when BNP was included into the multivariable model is also interesting. BNP which has been previously associated with left ventricular remodelling3,4 could be the marker of choice in clinical practice. However, due to the limited number of patients in their data set (n = 40), we believe that the findings of Papadopoulos et al. are only hypothesis-generating and that further prospective studies are needed to determine the better biological marker(s) for risk prediction. Besides stress hyperglycaemia, markers of neurohormonal activation, inflammatory markers also would be interesting candidates for such a study.
References
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