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Hyperglycemia and Outcome After Myocardial Infarction and Cardiac Surgery: So What?

Department of Cardiac-Thoracic-Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria; michael.hiesmayr{at}meduniwien.ac.at

Hyperglycemia is a frequent observation during acute illness such as myocardial infarction and after major surgery. The proportion of patients with hyperglycemia may be as high as 95% to 100% after cardiac surgery. This stress-induced hyperglycemia has a detrimental effect on outcome after myocardial infarction and cardiac surgery. Mortality may increase by a factor of 4, especially in non-diabetic patients. Control of hyperglycemia to normalize blood glucose is associated with a clear clinical benefit. This effect is most beneficial in nondiabetic patients with hyperglycemia. The exact target level of glycemia is still a matter of investigation, but normalization to values between 80 and 125 mg/dL is probably optimal.

Key Words: stress hyperglycemia • myocardial infarction • cardiac surgery

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 10, No. 3, 220-223 (2006)
DOI: 10.1177/1089253206291139


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