Peri-procedural tight glycemic control during early percutaneous coronary intervention up-regulates endothelial progenitor cell level and differentiation during acute ST-elevation myocardial infarction: Effects on myocardial salvage

التفاصيل البيبلوغرافية
العنوان: Peri-procedural tight glycemic control during early percutaneous coronary intervention up-regulates endothelial progenitor cell level and differentiation during acute ST-elevation myocardial infarction: Effects on myocardial salvage
المؤلفون: MARFELLA, Raffaele, RIZZO, Maria Rosaria, Siniscalchi M, Paolisso P, BARBIERI, Michelangela, Sardu C, Savinelli A, Angelico N, Del Gaudio S, Esposito N, RAMBALDI, Pier Francesco, D'Onofrio N, MANSI, Luigi, Mauro C, PAOLISSO, Giuseppe, BALESTRIERI, Maria Luisa, D'ONOFRIO, NUNZIA
المساهمون: Marfella, Raffaele, Rizzo, Maria Rosaria, Siniscalchi, M, Paolisso, P, Barbieri, Michelangela, Sardu, C, Savinelli, A, Angelico, N, Del Gaudio, S, Esposito, N, Rambaldi, Pier Francesco, D'Onofrio, N, Mansi, Luigi, Mauro, C, Paolisso, Giuseppe, Balestrieri, Maria Luisa, D'Onofrio, Nunzia
المصدر: International Journal of Cardiology. 168(4):3954-3962
بيانات النشر: Elsevier BV, 2013.
سنة النشر: 2013
مصطلحات موضوعية: Adult, Blood Glucose, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Peri, Endothelial progenitor cell, Myocardial infarction, PBMC, PCI, SIRT1, Percutaneous Coronary Intervention, SIRT1, St elevation myocardial infarction, Internal medicine, Preoperative Care, medicine, Humans, Prospective Studies, Endothelial progenitor cells, cardiovascular diseases, Myocardial infarction, Progenitor cell, Cells, Cultured, Aged, Glycemic, Salvage Therapy, business.industry, Myocardium, Stem Cells, Endothelial Cells, Percutaneous coronary intervention, Cell Differentiation, Middle Aged, medicine.disease, Treatment Outcome, surgical procedures, operative, Glycemic Index, myocardial salvage, Conventional PCI, Cardiology, Female, business, Cardiology and Cardiovascular Medicine, Follow-Up Studies
الوصف: BACKGROUND: We examined the effects of peri-procedural intensive glycemic control during early percutaneous coronary intervention (PCI) on the number and differentiation of endothelial progenitor cells (EPCs) and myocardial salvage (MS) in hyperglycemic patients with first ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: We conducted a randomized, prospective, open label study on 194 patients with STEMI undergoing PCI: 88 normoglycemic patients (glucose < 140 mg/dl) served as the control group. Hyperglycemic patients (glucose ≥140 mg/dl) were randomized to intensive glycemic control (IGC) for almost 24 h after PCI (n = 54; 80-140 mg/dl) or conventional glycemic control (CGC, n = 52; 180-200 mg/dl). EPC number, differentiation, and SIRT1expression were assessed immediately before, 24 h, 7, 30 and 180 days after PCI. The primary end point of the study was salvage index, measured as the proportion of initial perfusion defect (acute technetium-99m sestamibi scintigraphy, performed 5 to 7 days after STEMI) and myocardium salvaged by therapy (6 months after STEMI). Hyperglycemic patients had lower EPC number and differentiation and lower SIRT1 levels than normoglycemic patients (P < 0.01). After the insulin infusion, mean plasma glucose during peri-procedural period was greater in CGC group than in IGC group (P < 0.001). The EPC number, their capability to differentiate, and SIRT1 levels were significantly higher in IGC group than in CGC, peaking after 24 h (P < 0.01). In the IGC group, the salvage index was greater than in patients treated with CGC (P < 0.001). CONCLUSIONS: Optimal peri-procedural glycemic control, by increasing EPC number and their capability to differentiate, may improve the myocardial salvage.
تدمد: 0167-5273
DOI: 10.1016/j.ijcard.2013.06.053
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::100fb815e75be8d3ad268f7459b333f4
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....100fb815e75be8d3ad268f7459b333f4
قاعدة البيانات: OpenAIRE
الوصف
تدمد:01675273
DOI:10.1016/j.ijcard.2013.06.053