GLP 1 receptor agonists, glycemic variability, oxidative stress and acute coronary syndrome

Abstract

Glycemic variability (GV) has been recently described as an independent cardiovascular risk factor in patients with acute coronary syndrome (ACS). Also, new findings suggest that GV plays an important role in the development of complications related to impaired glucose metabolism and oxidative stress. On the other hand, although treatment for diabetes can reduce HbA1c in a similar extent their effectiveness over GV can be radically different. Patients in the acute setting of a coronary syndrome should be strictly monitorized to maintain glucose within recommended values; avoiding values lower than 90 mg/dL (5 mmol/L) and higher than 180 mg/dL (10 mmol/L). Also, evidence suggests the importance of not only maintaining glucose within certain values but also decreasing short-term GV as it has been associated with an increase in MACE in these patients. GLP-1 receptor agonists (GLP-1 RA) have demonstrated a decrease in GV and oxidative stress; therefore, the aim of this paper is to hypothesize the beneficial effect of GLP-1 RA in short-term GV and oxidative stress during the initial period of an ACS.