Key result
Insulin infusion prevented QTc prolongation at 24 hours, and mean blood glucose >8.0 mmol/l was associated with more new ECG conduction abnormalities than <=8.0 mmol/l.
Why the study?
Does insulin infusion improve electrocardiographic features of myocardial electrical activity in AMI patients with diabetes or hyperglycaemia?
RCT
randomized
Does insulin infusion improve electrocardiographic features of myocardial electrical activity in AMI patients with diabetes or hyperglycaemia?
Insulin infusion prevents QTc prolongation and strict glycemic control reduces new ECG conduction abnormalities in patients with AMI and hyperglycemia.
Answers are grounded in this paper and cite their sources.
Supports insulin infusion for glycemic control in hyperglycemic AMI; extends RCT evidence on ECG safety endpoints.
AIMS: To determine the effects of insulin infusion and blood glucose levels during acute myocardial infarction (AMI) on electrocardiographic (ECG) features of myocardial electrical activity. METHODS: ECGs at admission and 24 h were examined in a randomized study of insulin infusion vs. routine care for AMI patients with diabetes or hyperglycaemia. Results were analysed according to treatment allocation and also according to average blood glucose level. RESULTS: ECG characteristics were similar at admission in both groups. Patients allocated to conventional treatment had prolongation of the QT interval (QTc) after 24 h but those receiving infused insulin did not. In patients with a mean blood glucose in the first 24 h > 8.0 mmol/l, new ECG conduction abnormalities were significantly more common than in patients with mean blood glucose <or= 8.0 mmol/l (15.0% vs. 6.0%, P < 0.05). CONCLUSIONS: Prevention of QTc prolongation by administration of insulin may reflect a protective effect on metabolic and electrical activity in threatened myocardial tissue. Abnormalities of cardiac electrical conduction may also be influenced by blood glucose.
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Gan et al. (2008) conducted an RCT in Acute myocardial infarction with diabetes or hyperglycaemia. Insulin infusion vs. Routine care was evaluated on Electrocardiographic (ECG) features of myocardial electrical activity (QTc prolongation and new conduction abnormalities). Insulin infusion prevented QTc prolongation at 24 hours, and mean blood glucose >8.0 mmol/l was associated with more new ECG conduction abnormalities than <=8.0 mmol/l.
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