European Heart Journal Advance Access published online on February 21, 2007
European Heart Journal, doi:10.1093/eurheartj/ehl546
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Stress hyperglycaemia is an independent predictor of left ventricular remodelling after first anterior myocardial infarction in non-diabetic patients
1 Service de Cardiologie C, Hôpital Cardiologique, Centre Hospitalier Régional et Universitaire de Lille, Boul. Prof. Leclercq, 59037 Lille Cedex, France
2 Faculté de Médecine de Lille, Lille, France
3 Inserm U744, Institut Pasteur de Lille, Université de Lille 2, Lille, France
4 Centre Hospitalier de Dunkerque, Dunkerque, France
5 Centre Hospitalier de Béthune, Béthune, France
6 Centre Hospitalier de Boulogne, Boulogne, France
7 Centre Hospitalier de St Omer, St Omer, France
8 Centre Hospitalier de Roubaix, Roubaix, France
9 Centre Hospitalier de Douai, Douai, France
Received 10 August 2006; revised 14 January 2007; accepted 25 January 2007.
* Corresponding author. Tel: +33 3 20 44 50 45; fax: +33 3 20 44 48 81. E-mail address: cbauters{at}chru-lille.fr
Aims: Stress hyperglycaemia (SH) is associated with adverse outcome in patients with acute myocardial infarction (MI) but the mechanisms underlying this association are unknown. Our hypothesis was that SH on admission for acute MI may be associated with left ventricular (LV) remodelling.
Methods and results: We analysed LV remodelling in 162 non-diabetic patients with anterior MI. SH was defined as a glycaemia on admission 
7 mmol/L. Systematic echocardiographic follow-up was performed at 3 months and 1 year after MI. The changes in end-diastolic volume (EDV) and end-systolic volume (ESV) from baseline to 1 year were 11.4 ± 16.5 and 6.4 ± 12.4 ml/m2, respectively, in patients with SH vs. 1.9 ± 11.1 and 0.2 ± 8.5 ml/m2, respectively, in patients without SH (both P < 0.0001). When LV remodelling was defined as a >20% increase in EDV, it was observed in 46% patients in the SH group vs. 19% patients in the no SH group (P = 0.0008). By multivariable analysis, baseline wall motion score index (P = 0.001) and SH (P = 0.009) were independently associated with changes in EDV. SH was an independent predictor of LV remodelling [adjusted OR: 3.22 (1.31–7.94)].
Conclusion: SH is a major and independent predictor of LV remodelling after anterior MI in non-diabetic patients.
Key Words: Remodelling • Myocardial infarction • Glucose
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