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Acute coronary syndromes: meticulous care is life-saving

A. Norhammar1

Department of Cardiology, Karolinska Hospital, Stockholm, Sweden

1 Anna Norhammar, MD, Department of Cardiology, Karolinska Hospital, SE-171 76 Stockholm, Sweden.

Abstract

This is a short summary of a previous published paper in European Heart Journal Supplements (1). It focus on the actual treatment of patients with diabetes an acute coronary syndromes and how to improve prognosis in this patient cohort. The number of people with diabetes mellitus is currently increasing dramatically. Patients with diabetes have not experienced the reduction in mortality rates that recently have been observed in non-diabetic people. A recent study that used serial oral glucose tolerance testing (OGTT) following an acute myocardial infarction indicates that the prevalence of diabetes and impaired glucose tolerance is much higher than previous expected. It also seem that evidence based treatment is less well utilised in the diabetic cohort.

Key Words: Diabetes • mortality myocardial infarction • treatment • metabolic control • hyperglycemia • risk • glucose abnomralities

References

  1. Rydén L, Malmberg K. Who are the enemies. Diabetes mellitus — a major risk factor for ischaemic myocardial injury: new directions in the management of acute coronary syndromes in the diabetic patient. Eur Heart J. 2002;4(suppl G): in press
  2. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025. Prevalence, numerical estimates, and projections. Diabetes Care. 1998;21:1414–1431[Abstract]
  3. Malmberg K, Norhammar A, Wedel H, Ryden L. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes and acute myocardial infarction. Circulation. 1999;99:2626–2632[Abstract/Free Full Text]
  4. Van den Berge G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345:1359–1367[Abstract/Free Full Text]
  5. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–1350[Abstract/Free Full Text]

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This Article
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