Myocardial Infarction Clinical Trial
Official title:
Phase 4 Study of the Effect of Statin Treatment on Insulin Sensitivity During Myocardial Infarction
Stress hyperglycemia during myocardial infarction (MI) is related to mortality at short and long term. Recent studies, however, revealed that chronic statin treatment may decrease both insulin sensitivity and secretion immediately after statin therapy initiation. This study aim was to investigate the dose-dependent effect of statins on insulin sensitivity in patients in the acute phase of MI.
Stress hyperglycemia during myocardial infarction (MI) is a predictor of worse prognosis at
short and long term. From the mechanistic standpoint, hyperglycemia can attenuate
thrombolysis, increase platelet aggregation, induce coronary vasoconstriction, reduce oxygen
transport and prolong endothelial inflammation after MI. Consistently, observational data
indicates that glucose normalization improves survival in hyperglycemic patients
hospitalized with MI.
High dose potent statins have been included in the early treatment of acute coronary
syndromes (ACS) based upon a broad range of potentially beneficial mechanisms. Recent
studies, however, revealed that chronic statin treatment may increase the incidence of type
2 diabetes mellitus in a dose-dependent manner. Moreover, according to studies in cellular
and animal models, such decrease in insulin sensitivity may be observed immediately after
statin therapy initiation. By inference, one may speculate that statin treatment initiated
at the acute phase of MI may potentially favor the appearance or aggravation of stress
hyperglycemia. To date, however, this hypothesis has not been investigated. Hence, this
study aim was to investigate the dose-dependent effect of statins on insulin sensitivity in
patients in the acute phase of MI.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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