Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia

Perché valutare la glicemia acuta e cronica in pazienti diabetici con infarto miocardico acuto e alti livelli glicemici al ricovero? (J Am Heart Assoc 2018 Apr 13)

23 April Apr 2018 one month ago
  • Marenzi G, Cosentino N, Milazzo V, De Metrio M, Rubino M, Campodonico J, Moltrasio M, Marana I, Grazi M, Lauri G, Bonomi A, Barbieri S, Assanelli E, Dalla Cia A, Manfrini R, Ceriani R, Bartorelli A

In acute myocardial infarction, acute hyperglycemia is a predictor of acute kidney injury (AKI), particularly in patients without diabetes mellitus. This emphasizes the importance of an acute glycemic rise rather than glycemia level at admission.

The Authors investigated whether, in diabetic patients with acute myocardial infarction, the combined evaluation of acute and chronic glycemic levels may have better prognostic value for AKI than admission glycemia.

According to the conclusions, the ability of admission glycemia to predict acute kidney injury in diabetic patients with acute myocardial infarction, who are treated with percutaneous coronary intervention, improves significantly if average chronic glucose, as estimated by glycosylated hemoglobin, is also taken into account.

These findings highlight that an acute glucose‐level rise, unlike chronic elevation, is an important predisposing factor for acute kidney injury. Therefore, assessing the acute and chronic glycemia in diabetic patients with acute myocardial infarction and high admission glycemic levels may help physicians identify true stress hyperglycemia and discern high‐risk patients who may benefit from renal preventive strategies.

Reference
1. Marenzi G, Cosentino N, Milazzo V, De Metrio M, Rubino M, Campodonico J, Moltrasio M, Marana I, Grazi M, Lauri G, Bonomi A, Barbieri S, Assanelli E, Dalla Cia A, Manfrini R, Ceriani R, Bartorelli A. Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia. J Am Heart Assoc 2018 Apr 13;7(8). Go to PubMed