IMR Press / RCM / Volume 7 / Issue S2 / pii/1561344061975-2050906588

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Mechanism by Which Hyperglycemia Plays a Role in the Setting of Acute Cardiovascular Illness
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1 Division of Cardiovascular Medicine, Bridgeport Hospital, Bridgeport, CT; Yale University School of Medicine, New Haven, CT
Rev. Cardiovasc. Med. 2006, 7(S2), 35–43;
Published: 20 February 2006
Acute hyperglycemia is associated with excess morbidity and mortality in acute cardiovascular illness in both diabetic and nondiabetic patients. Hyperglycemia is associated with altered myocardial energetics, but abnormalities in glucose oxidation and glycolysis do not fully account for this excess risk. Hyperglycemia leads to a pro-oxidative/ proinflammatory state that is associated with endothelial dysfunction, diminished coronary vasodilatory reserve, and a prothrombotic state. Hyperglycemia negates the protective effect of ischemic preconditioning and, most importantly, appears to interfere with the salutary effects of insulin in acute cardiovascular illness. Aggressive therapy with continuous infusion of insulin seems to improve a host of metabolic and physiologic effects associated with acute hyperglycemia and appears warranted if euglycemia can be maintained.
Acute coronary syndromes
Diabetes mellitus
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