Intensive management of hyperglycaemia in acute coronary syndromes. Study design and rationale of the BIOMArCS2 glucose trial

Diabetic Medicine

Volumn 28, Issue 10, 2011, Pages 1168-1175

  De Mulder, M ^a   Umans, V A ^a   Stam, F ^a   Cornel, J H ^a   Oemrawsingh, R M ^b   Boersma, E ^b  

^a Location Alkmaar   (Netherlands)

^b ERASMUS MEDICAL CENTER   (Netherlands)

Author keywords

Acute coronary syndrome; Biomarkers; Diabetes; Hyperglycaemia; Intensive glucose regulation

Indexed keywords

AMINO TERMINAL PRO BRAIN NATRIURETIC PEPTIDE; BIOLOGICAL MARKER; C REACTIVE PROTEIN; CD40 ANTIGEN; CREATINE KINASE MB; GELATINASE A; GELATINASE B; GLUCOSE; INSULIN ASPART; INTERLEUKIN 10; INTERLEUKIN 6; INTERLEUKIN 8; PLACENTAL GROWTH FACTOR; PREGNANCY ASSOCIATED ALPHA2 GLYCOPROTEIN; REDUCED NICOTINAMIDE ADENINE DINUCLEOTIDE PHOSPHATE OXIDASE; TROPONIN I;

ACUTE CORONARY SYNDROME; ADULT; ARTICLE; BLOOD GLUCOSE METER; CARDIOVASCULAR RISK; CELL ACTIVATION; DIET; DIET RESTRICTION; ELECTROCARDIOGRAM; ENDOTHELIUM CELL; GLUCOSE BLOOD LEVEL; GLYCEMIC CONTROL; GLYCOLYSIS; HEART INFARCTION; HEART LEFT VENTRICLE FUNCTION; HOSPITAL ADMISSION; HUMAN; HYPERCOAGULABILITY; HYPERGLYCEMIA; INFLAMMATION; INFUSION; INSULIN RESISTANCE; INTENSIVE CARE; MAJOR CLINICAL STUDY; MULTICENTER STUDY; MYOCARDIAL INFARCT SIZE; MYOCARDIAL PERFUSION IMAGING; NON INSULIN DEPENDENT DIABETES MELLITUS; NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; ORAL GLUCOSE TOLERANCE TEST; OUTCOME ASSESSMENT; OXIDATIVE STRESS; POINT OF CARE TESTING; PRACTICE GUIDELINE; RISK ASSESSMENT; THORAX PAIN; VASODILATATION;

ACUTE CORONARY SYNDROME; BIOLOGICAL MARKERS; BLOOD GLUCOSE; DIABETIC ANGIOPATHIES; FEMALE; GLUCOSE TOLERANCE TEST; GUIDELINES AS TOPIC; HOSPITAL MORTALITY; HUMANS; HYPERGLYCEMIA; INSULIN; MALE; MONITORING, AMBULATORY; MYOCARDIAL INFARCTION; PROGNOSIS; RISK FACTORS; TREATMENT OUTCOME;

EID: 80053031245     PISSN: 07423071     EISSN: 14645491     Source Type: Journal    
DOI: 10.1111/j.1464-5491.2011.03307.x     Document Type: Article

References (35)

1. Norhammar AM, Ryden L, Malmberg K. Admission plasma glucose. Independent risk factor for long-term prognosis after myocardial infarction even in non-diabetic patients. Diabetes Care 1999; 22: 1827-1831.
2. Stranders I, Diamant M, van Gelder RE, Spruijt HJ, Twisk JW, Heine RJ et al. Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch Intern Med 2004; 164: 982-988.
3. Bolk J, van der Ploeg T, Cornel JH, Arnold AE, Sepers J, Umans VA. Impaired glucose metabolism predicts mortality after a myocardial infarction. Int J Cardiol 2001; 79: 207-214.
4. Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2008; 117: 1610-1619.
5. de Mulder M, Cornel JH, van der Ploeg T., Boersma E, Umans VA. Elevated admission glucose is associated with increased long-term mortality in myocardial infarction patients, irrespective of the initially applied reperfusion strategy. Am Heart J 2010; 160: 412-419.
6. Goyal A, Mahaffey KW, Garg J, Nicolau JC, Hochman JS, Weaver WD et al. Prognostic significance of the change in glucose level in the first 24h after acute myocardial infarction: results from the CARDINAL study. Eur Heart J 2006; 27: 1289-1297.
7. Malmberg K, Ryden L, Efendic S, Herlitz J, Nicol P, Waldenstrom A et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1year. J Am Coll Cardiol 1995; 26: 57-65.
8. Malmberg K, Ryden L, Wedel H, Birkeland K, Bootsma A, Dickstein K et al. Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI2): effects on mortality and morbidity. Eur Heart J 2005; 26: 650-661.
9. Cheung NW, Wong VW, McLean M. The Hyperglycemia: Intensive Insulin Infusion in Infarction (HI-5) study: a randomized controlled trial of insulin infusion therapy for myocardial infarction. Diabetes Care 2006; 29: 765-770.
10. Diaz R, Goyal A, Mehta SR, Afzal R, Xavier D, Pais P et al. Glucose-insulin-potassium therapy in patients with ST-segment elevation myocardial infarction. J Am Med Assoc 2007; 298: 2399-2405.
11. Marfella R, Di Filippo C, Portoghese M, Ferraraccio F, Rizzo MR, Siniscalchi M et al. Tight glycemic control reduces heart inflammation and remodeling during acute myocardial infarction in hyperglycemic patients. J Am Coll Cardiol 2009; 53: 1425-1436.
12. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M et al. Intensive insulin therapy in the critically ill patients. N Engl J Med 2001; 345: 1359-1367.
13. Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360: 1283-1297.
14. de Mulder M, Oemrawsingh RM, Stam F, Boersma E, Umans VA. Current management of hyperglycemia in acute coronary syndromes: a national Dutch survey. Crit Pathw Cardiol 2009; 8: 66-70.
15. Kosiborod M, Rathore SS, Inzucchi SE, Masoudi FA, Wang Y, Havranek EP et al. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation 2005; 111: 3078-3086.
16. Lecomte P, Foubert L, Nobels F, Coddens J, Nollet G, Casselman F et al. Dynamic tight glycemic control during and after cardiac surgery is effective, feasible, and safe. Anesth Analg 2008; 107: 51-58.
17. Bode BW, Braithwaite SS, Steed RD, Davidson PC. Intravenous insulin infusion therapy: indications, methods, and transition to subcutaneous insulin therapy. Endocr Pract 2004; 10: 71-80.
18. de Mulder M, Zwaan E, Wielinga Y, Stam F, Umans VA. How to implement a clinical pathway for intensive glucose regulation in acute coronary syndromes. Crit Pathw Cardiol 2009; 8: 72-78.
19. Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 2008; 29: 2909-2945.
20. Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 2007; 28: 1598-1660.
21. Cardiology Audit and Registration Data Standards (CARDS). Acute Coronary Syndrome Data Definitions. Available at Last accessed 14 December 2010.
22. Flynn MR, Barrett C, Cosio FG, Gitt AK, Wallentin L, Kearney P et al. The Cardiology Audit and Registration Data Standards (CARDS), European data standards for clinical cardiology practice. Eur Heart J 2005; 26: 308-313.
23. Zeymer U, Schroder K, Wegscheider K, Senges J, Neuhaus KL, Schroder R. ST resolution in a single electrocardiographic lead: a simple and accurate predictor of cardiac mortality in patients with fibrinolytic therapy for acute ST-elevation myocardial infarction. Am Heart J 2005; 149: 91-97.
24. Steen H, Giannitsis E, Futterer S, Merten C, Juenger C, Katus HA. Cardiac troponinT at 96hours after acute myocardial infarction correlates with infarct size and cardiac function. J Am Coll Cardiol 2006; 48: 2192-2194.
25. Sun D, Nguyen N, DeGrado TR, Schwaiger M, Brosius FC III. Ischemia induces translocation of the insulin-responsive glucose transporter GLUT4 to the plasma membrane of cardiac myocytes. Circulation 1994; 89: 793-798.
26. Mohanty P, Hamouda W, Garg R, Aljada A, Ghanim H, Dandona P. Glucose challenge stimulates reactive oxygen species (ROS) generation by leucocytes. J Clin Endocrinol Metab 2000; 85: 2970-2973.
27. Dandona P, Chaudhuri A, Ghanim H, Mohanty P. Effect of hyperglycemia and insulin in acute coronary syndromes. Am J Cardiol 2007; 99: 12H-18H.
28. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111: 1448-1454.
29. Iwakura K, Ito H, Ikushima M, Kawano S, Okamura A, Asano K et al. Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction. J Am Coll Cardiol 2003; 41: 1-7.
30. Chaudhuri A, Janicke D, Wilson MF, Tripathy D, Garg R, Bandyopadhyay A et al. Anti-inflammatory and profibrinolytic effect of insulin in acute ST-segment-elevation myocardial infarction. Circulation 2004; 109: 849-854.
31. Chaudhuri A, Janicke D, Wilson M, Ghanim H, Wilding GE, Aljada A et al. Effect of modified glucose-insulin-potassium on free fatty acids, matrix metalloproteinase, and myoglobin in ST-elevation myocardial infarction. Am J Cardiol 2007; 100: 1614-1618.
32. Dandona P, Chaudhuri A, Ghanim H, Mohanty P. Proinflammatory effects of glucose and anti-inflammatory effect of insulin: relevance to cardiovascular disease. Am J Cardiol 2007; 99: 15B-26B.
33. Kosiborod M, Inzucchi SE, Krumholz HM, Xiao L, Jones PG, Fiske S et al. Glucometrics in patients hospitalized with acute myocardial infarction: defining the optimal outcomes-based measure of risk. Circulation 2008; 117: 1018-1027.
34. Pinto DS, Skolnick AH, Kirtane AJ, Murphy SA, Barron HV, Giugliano RP et al. U-shaped relationship of blood glucose with adverse outcomes among patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol 2005; 46: 178-180.
35. Jonassen AK, Sack MN, Mjos OD, Yellon DM. Myocardial protection by insulin at reperfusion requires early administration and is mediated via Akt and p70s6 kinase cell-survival signaling. Circ Res 2001; 89: 1191-1198.