Serum glucagon and insulin levels and their relationship to blood glucose values in patients with acute myocardial infarction and acute coronary insufficiency

Abstract

Fasting serum glucagon, insulin and glucose levels were determined in 25 patients with acute myocardial infarction 1 day after their admission to the hospital and, in most instances, once again at a later date. Two control groups were used, one with coronary insufficiency but without myocardial infarction (10 patients) and the other without clinically recognizable coronary artery disease (12 patients). Serum glucagon levels were significantly higher in the patients with acute myocardial infarction on admission (121.6 ± 15.3 pg/ml) than in the other two groups and highest in patients with acute myocardial infarction and cardiogenic shock (239.3 ± 31 pg/ml, p < 0.001). Glucagon levels were elevated even in the three patients with cardiogenic shock who were not receiving catecholamines. Serum glucose values were also significantly higher in patients with acute myocardial infarction (155 ± 13.9 mg/100 ml), but serum insulin levels were not significantly different from those in patients with coronary insufficiency. These data suggest that the hyperglycemia of patients with acute myocardial infarction may be in part due to hyperglucagonemia.