PMID- 21345499
OWN - NLM
STAT- MEDLINE
DCOM- 20120920
LR  - 20131121
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 155
IP  - 1
DP  - 2012 Feb 23
TI  - Acute glucose dysmetabolism in the elderly with ST elevation myocardial 
      infarction submitted to mechanical revascularization.
PG  - 66-9
LID - 10.1016/j.ijcard.2011.01.075 [doi]
AB  - Though age is a predictor of adverse events after acute coronary syndrome, 
      including in-hospital and post-hospital mortality rates, elderly patients are 
      under-represented in randomized trials evaluating strategies of early coronary 
      revascularization in acute myocardial infarction. Several factors can account for 
      the unfavorable outcome of the elderly, comprising increased glucose values. 
      Diabetes is more common in the elderly patients with acute myocardial infarction 
      in respect to younger patients and elevated glucose, though common, are rarely 
      treated and associated with increased mortality, particularly in those without 
      recognized diabetes. Age itself is thought to affect the acute glucose response 
      to stress. Human aging is associated with impaired beta-cell sensitivity to glucose 
      and impaired beta-cell compensation to insulin resistance and older people exhibit 
      an impaired glucose response after injury characterized by a more marked 
      increases in endogenous glucose production. In the early phase of ST elevation 
      myocardial infarction (STEMI), the acute glucose response to stress comprises not 
      only hyperglycemia but also insulin-resistance (assessed by the Homeostatic Model 
      Assessment). Recently it has been documented in 346 STEMI patients submitted to 
      mechanical revascularization that the acute glucose response to myocardial injury 
      differs in respect to age, since older patients showed the highest glucose levels 
      and the poorest glycemic control during ICCU stay in the lack of differences in 
      insulin resistance incidence. Taking into account that aging impairs the acute 
      glucose response to stress in elderly STEMI patients, further studies are needed 
      to establish whether a different (more aggressive) therapeutic regime is needed 
      in this subgroup of patients at higher risk.
CI  - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved.
FAU - Lazzeri, Chiara
AU  - Lazzeri C
AD  - Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda 
      Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. 
      lazzeric@libero.it
FAU - Valente, Serafina
AU  - Valente S
FAU - Chiostri, Marco
AU  - Chiostri M
FAU - Picariello, Claudio
AU  - Picariello C
FAU - Gensini, Gian Franco
AU  - Gensini GF
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20110222
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Blood Glucose)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Aged
MH  - Aging/*blood
MH  - Blood Glucose/*metabolism
MH  - Glucose/metabolism
MH  - Humans
MH  - Hyperglycemia/blood/therapy
MH  - Insulin Resistance
MH  - Myocardial Infarction/*blood/*therapy
MH  - *Myocardial Revascularization/methods
MH  - Risk Factors
MH  - Time Factors
EDAT- 2011/02/25 06:00
MHDA- 2012/09/21 06:00
CRDT- 2011/02/25 06:00
PHST- 2010/12/01 00:00 [received]
PHST- 2011/01/01 00:00 [accepted]
PHST- 2011/02/25 06:00 [entrez]
PHST- 2011/02/25 06:00 [pubmed]
PHST- 2012/09/21 06:00 [medline]
AID - S0167-5273(11)00122-7 [pii]
AID - 10.1016/j.ijcard.2011.01.075 [doi]
PST - ppublish
SO  - Int J Cardiol. 2012 Feb 23;155(1):66-9. doi: 10.1016/j.ijcard.2011.01.075. Epub 
      2011 Feb 22.