Acute hyperglycaemia prevents the protective effect of pre-infarction angina on microvascular function after primary angioplasty for acute myocardial infarction

Abstract

The protective effect of PIA on microvascular function was attenuated in patients with acute hyperglycaemia, resulting in unfavourable functional recovery.

Remote Ischemic Preconditioning Improves Outcome at 6 Years After Elective Percutaneous Coronary Intervention

“…17 Diabetic resistance to conditioning has been previously described 18 and may be attributable to hyperglycemia, exacerbating the ischemia reperfusion injury. 19,20 However, we did not demonstrate a link between glycemic control and MACCE rate in RIPC-treated patients with diabetes mellitus. Others have reported that the conditioning threshold required to protect diabetic myocardium is higher because of alterations in diabetic mitochondrial ATP-sensitive potassium channels.…”

“…RIPC, first demonstrated to provide cardioprotection by Przyklenk et al 15 20 years ago, has subsequently been shown to reduce the incidence of procedure-related cTnI release in pediatric cardiac surgery, 9 adult bypass surgery, 10,11 and abdominal aortic aneurysm repair, 12 as well as in the setting of primary PCI. 13 Elective PCI produces a predictable ischemia reperfusion injury in 30% of patients, and therefore, we anticipated that this would be ideally suited to RIPC cardioprotection, during the early window of protection between 1 and 2 hours after 3 cycles of 5-minute blood pressure cuff inflations.…”

Prognostic correlates of combined coronary flow reserve assessment on left anterior descending and right coronary artery in patients with negative stress echocardiography by wall motion criteria

“…In particular, a normal CFR in both coronary vessels was highly predictive of a very favourable outcome, indicating absence of either prognostically meaningful epicardial artery stenosis and/or coronary microcirculation impairment. Explanations for reduced CFR in the absence of stress-induced wall motion abnormalities include mild-to-moderate epicardial coronary artery stenosis,25 left ventricular hypertrophy,26 severe epicardial coronary artery stenosis in the presence of anti-ischaemic therapy27282930 and severe microvascular coronary disease in the presence of patent epicardial coronary arteries 313233343536. All these conditions may adversely affect prognosis.…”

Conditioning of the heart: From pharmacological interventions to local and remote protection

“…K ATP channels are altered in diabetes [84] and oral hypoglycemic drugs affect these channels as well [11]. Furthermore, hyperglycemia by itself abolishes the conditioning effect [85].…”