Abstract 12081: Glycemic Variability as Determined by a Continuous Glucose Monitoring System Predicts Left Ventricular Dysfunction in Patients With a First ST-Segment Elevation Myocardial Infarction

Abstract

Background: Glycemic Variability (GV) may play an important role in development of cardiovascular disease however the clinical significance of GV is not fully understood in patients with ST-segment elevation myocardial infarction (STEMI). We explored the clinical utility of GV using continuous glucose monitoring system (CGMS; iPro2, Medtronic, USA). Methods: Seventy-four patients (66 males, 63±12 years) with a first STEMI were enrolled. STEMI was de[[Unable to Display Character: fi]]ned as chest pain lasting for at least 30 minutes accompanied by ST-segment elevation and an increase in the serum peak-creatine phosphokinase (CPK) level to more than twice the upper limit of normal. All patients were equipped with a CGMS 1 week after admission and GV was assessed by measuring the Mean Amplitude of Glycemic Excursion (MAGE) during 24 hours with 3 regular meals. At 7 month, all patients underwent conventional 2D echocardiography and blood sampling (BNP; brain natriuretic peptide) to explore the effect of GV to their cardiac function. Results: On univariate analysis male, culprit left anterior descending artery (LAD), peak CK-MB and MAGE were predictors of decreased left ventricular ejection fraction (LVEF). On multivariate analysis higher MAGE level was an independent predictor of decreased LVEF. Higher MAGE level was also an independent predictor of higher BNP level at 7 month. Conclusions: GV was an independent predictor of left ventricular dysfunction in patients with a first STEMI.