Journal article 941 views
The effects of intravenous insulin infusions on early mortality for patients with acute coronary syndromes who present with hyperglycaemia: A matched propensity analysis using data from the MINAP database 2008–2012
,
Adam Timmis,
Ruoling Chen
European Heart Journal: Acute Cardiovascular Care, Volume: 4, Issue: 4, Pages: 344 - 352
Swansea University Author:
Clive Weston
Full text not available from this repository: check for access using links below.
DOI (Published version): 10.1177/2048872614549733
Abstract
We compared 7 day survival for patients receiving IV insulin infusion (IVII) with those receiving routine care to control admission hyperglycaemia (>=11 mmol/l) in acute coronary syndrome.We used matched propensity analysis to examine observational data (2008-2012) from the Myocardial Ischaemia N...
| Published in: | European Heart Journal: Acute Cardiovascular Care |
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| ISSN: | 2048-8726 2048-8734 |
| Published: |
2015
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa18433 |
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| Abstract: |
We compared 7 day survival for patients receiving IV insulin infusion (IVII) with those receiving routine care to control admission hyperglycaemia (>=11 mmol/l) in acute coronary syndrome.We used matched propensity analysis to examine observational data (2008-2012) from the Myocardial Ischaemia National Audit Project. We matched 5974 pairs of patients. We separately examined outcomes for ST elevation (STEMI) and non ST segment elevation (NSTEMI) infarctions, and those without known diabetes and those with type 2 diabetes. Survival benefit from the use of IVII was seen only in patients with STEMI not known to have diabetes at admission (adjusted hazard ratio (HR) 0.77 (95% confidence interval (CI) 0.64-0.92), p=0.005). Those with STEMI and existing type 2 diabetes who received IVII showed similar outcomes to routine care (HR 0.99 (95% CI 0.80-1.23), p=0.931). In patients with NSTEMI IVII was associated with significantly worse adjusted 7 day survival outcome than routine care, regardless of diabetes status; for those without known diabetes, HR 1.50 (95% CI 1.04-2.16), p=0.029, and for those with type 2 diabetes, HR 1.35 (95% CI 1.08-1.70), p=0.010.As used in current clinical practice to treat hyperglycaemia in acute coronary syndromes, IVII appears to be of benefit only for patients with STEMI who are not known to have diabetes. IVII is associated with adverse early outcomes in patients with NSTEMI. |
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| Keywords: |
Acute Coronary syndrome; myocardial infarction; insulin; hyperglycaemia |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Issue: |
4 |
| Start Page: |
344 |
| End Page: |
352 |