February 26, 2008

National Effort Needed to Address Hyperglycemia in Heart Patients

TUESDAY, Feb. 26 (HealthDay News) -- A national effort is needed to deal with the effects of high blood sugar in heart patients, says an American Heart Association scientific statement released Monday.

The statement highlights a number of unanswered questions about the condition, also known as hyperglycemia, in people hospitalized with acute coronary syndrome (ACS), which includes heart attack and a variety of other cardiovascular conditions.

"Although studies indicate that one-fourth to one-half of ACS patients have hyperglycemia when they arrive at hospital, elevated blood sugar is frequently ignored despite being strongly associated with increased mortality," writing committee chair Dr. Prakash Deedwania, chief of cardiology at the VA Medical Center and the University of California, San Francisco, in Fresno, said in a prepared statement.

A number of studies have shown that hospitalized ACS patients with high blood sugar have increased rates of in-hospital complications and death. But much more needs to be learned about the link between hyperglycemia and poor outcomes in these patients. For example, it's unclear whether elevated blood sugar levels in ACS patients are a marker for heart muscle damage or actually cause the damage, Deedwania noted.

Since evidence about how best to approach glucose management in ACS patients is still being gathered, the AHA statement provides "a general reference" for medical teams treating these patients.

The statement recommends that all ACS patients with elevated blood sugar be screened for diabetes or prediabetes as part of their in-hospital evaluation. Blood sugar should be kept in the range of 90 to 140 mg/dL for ACS patients who have significant hyperglycemia on admission and are placed in the intensive care unit. Blood sugar levels should be kept below 189 mg/dL for ACS patients who aren't in the ICU.

The statement is published in the Feb. 26 issue of Circulation.

"This is a call to action for organizations such as the National Institutes of Health [NIH] to design appropriate large, randomized clinical trials where several of these critical and clinically important questions can be answered. Only then will we be able to find and implement treatments that may reduce deaths," Deedwania said.

More information

The American Diabetes Association has more about hyperglycemia.

-- Robert Preidt
SOURCE: American Heart Association, news release, Feb. 25, 2008
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