Title: Intensive Insulin Therapy versus Conventional Insulin Therapy in Post Myocardial Infarction Left Ventricular Remodelling

Authors: Lobna Farag El Tony, Salah Abdel-Azeem Argoon, Ahmad B. Elden, Walaa A. Khalifa

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i12.14

Abstract

Objectives: This study aimed to assess left ventricular (LV) remodelling in acute myocardial infarction (AMI) patients presented with admission hyperglycaemia (AH) with or without history of diabetes treated with either intensive insulin therapy (IIT) or conventional insulin therapy (CIT) and to compare the effect of both therapies on LV remodelling.

Patients and Methods:We conducted a prospective cohort study and analysed LV remodelling in 77 AMI patients. AH was defined as a glycaemia on admission > 140 mg/dl. We randomly assigned patients either IIT or CIT. Systematic echocardiographic study was performed at baseline and at 12 months later.

Results:The changes in LV end-diastolic volume (LVEDV) from baseline to 12 months follow up was 37.31±41.4 cm3in the CIT group and 39.49±41.18 cm3 in the IIT group (p value NS).When LV remodelling was defined as a >20% increase in LVEDV, it was observed in 94.4% of CIT group and in 91.3% in IIT group (p value NS).

Conclusions:We concluded that IIT hadn’t any significant difference than CIT on post AMI remodelling.

Keywords:admission hyperglycaemia, post myocardial infarction remodelling, intensive insulin therapy.

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Corresponding Author

Ahmad B. Elden

Assiut University, P.O. Box 71111 Assiut, Egypt

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