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March 1, 2014DiabetesOpen Access

Impact of Acute Hyperglycemia on Myocardial Infarct Size, Area at Risk, and Salvage in Patients With STEMI and the Association With Exenatide Treatment: Results From a Randomized Study

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Why the study?

Does intravenous exenatide improve myocardial salvage in patients with STEMI undergoing percutaneous coronary intervention, and is this effect dependent on admission hyperglycemia?

Population

210 patients with ST-segment elevation myocardial infarction (STEMI)

Comparison

Intravenous exenatide before percutaneous… vs Placebo before percutaneous coronary intervention

Design

RCT, randomized

Authors

JLJacob LønborgNVNiels VejlstrupHKHenning Kelbæk

Discussion

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Overview

Supports exenatide for myocardial salvage in STEMI independent of glycemia; extends cardioprotection evidence across glucose strata.

Structured PICO

Does intravenous exenatide improve myocardial salvage in patients with STEMI undergoing percutaneous coronary intervention, and is this effect dependent on admission hyperglycemia?

P
Population
210 patients with ST-segment elevation myocardial infarction (STEMI)
I
Intervention
Intravenous exenatide before percutaneous coronary intervention
C
Comparator
Placebo before percutaneous coronary intervention
O
Outcome
Infarct size, myocardial salvage, and area at risksurrogate

Cardioprotection by exenatide treatment in STEMI patients is independent of glucose levels at hospital admission, and hyperglycemia acts as a surrogate marker for the severity of risk and injury rather than directly reducing myocardial salvage.

Cite This Study

Lønborg et al. (2014) studied this question.

synapsesocial.com/papers/6a0042a72ff633f36577ddddhttps://doi.org/10.2337/db13-1849
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Exenatide Reduces Final Infarct Size in Patients With ST-Segment–Elevation Myocardial Infarction and Short-Duration of Ischemia2012 · 210 citations
  2. 2Prognostic Value of Admission Glycosylated Hemoglobin and Glucose in Nondiabetic Patients With ST-Segment–Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention2011 · 241 citations
  3. 3Reproducibility of Chronic Infarct Size Measurement by Contrast-Enhanced Magnetic Resonance Imaging2002 · 410 citations