ST elevation myocardial infarction glucose control: Difference between revisions

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==Guidelines (DO NOT EDIT)==
==Guidelines (DO NOT EDIT)==
* ''Class I''
===Class I===
An insulin infusion to normalize blood glucose is recommended for patients with STEMI and complicated courses. (Level of Evidence: B)
An insulin infusion to normalize blood glucose is recommended for patients with STEMI and complicated courses. (Level of Evidence: B)


* ''Class IIa''
===Class IIa===
1. During the acute phase (first 24 to 48 hours) of the management of STEMI in patients with hyperglycemia, it is reasonable to administer an insulin infusion to normalize blood glucose even in patients with an uncomplicated course. (Level of Evidence: B)  
1. During the acute phase (first 24 to 48 hours) of the management of STEMI in patients with hyperglycemia, it is reasonable to administer an insulin infusion to normalize blood glucose even in patients with an uncomplicated course. (Level of Evidence: B)  



Revision as of 16:06, 1 May 2009

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Guidelines (DO NOT EDIT)

Class I

An insulin infusion to normalize blood glucose is recommended for patients with STEMI and complicated courses. (Level of Evidence: B)

Class IIa

1. During the acute phase (first 24 to 48 hours) of the management of STEMI in patients with hyperglycemia, it is reasonable to administer an insulin infusion to normalize blood glucose even in patients with an uncomplicated course. (Level of Evidence: B)

2. After the acute phase of STEMI, it is reasonable to individualize treatment of diabetics, selecting from a combination of insulin, insulin analogs, and oral hypoglycemic agents that achieve the best glycemic control and are well tolerated. (Level of Evidence: C)

Sources

  • The 2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction [1]
  • The 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction [2]

References

  1. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK (2004). "ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction)". Circulation. 110 (9): e82–292. PMID 15339869. Unknown parameter |month= ignored (help)
  2. Antman EM, Hand M, Armstrong PW; et al. (2008). "2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee". Circulation. 117 (2): 296–329. doi:10.1161/CIRCULATIONAHA.107.188209. PMID 18071078. Unknown parameter |month= ignored (help)


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