Shunsuke Kataoka

Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome

BACKGROUND Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS). METHODSANDRESULTS We prospectively investigated the clinical impact of glycemic variability (GV), as determined on continuous glucose monitoring system (CGMS), on RP of non-culprit lesions in 88 patients with ACS. RP was defined as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis <50%; development of a new stenosis ≥30% in a previously normal segment; or progression of any stenosis to total occlusion. Patients were classified into 2 groups according to the presence (progressor, n=20) or absence (non-progressor, n=68) of RP. All patients were equipped with a CGMS during the stable phase, and mean amplitude of glycemic excursion (MAGE) was calculated as a marker of GV. Mean MAGE was significantly higher in progressors than in non-progressors (55±19 mg/dl vs. 37±18 mg/dl, P<0.01). On multiple logistic regression analysis, MAGE was an independent predictor of RP (odds ratio, 1.06 per 1 mg/dl; P<0.01). CONCLUSIONS MAGE early after the onset of ACS is a predictor of RP of non-culprit lesions.

Glycemic Variability Determined by Continuous Glucose Monitoring System Predicts Left Ventricular Remodeling in Patients With a First ST-Segment Elevation Myocardial Infarction

BACKGROUND Impaired glucose metabolism plays an important role in patients with acute myocardial infarction, but the clinical significance of glycemic variability (GV) early after the onset of ST-segment elevation myocardial infarction (STEMI) remains to be fully elucidated. METHODS AND RESULTS We prospectively investigated the clinical impact of GV, as determined by a continuous glucose monitoring system (CGMS), on left ventricular remodeling (LVR) assessed by cardiac magnetic resonance imaging (CMR) in 69 patients (63±13 years, 59 men) with a first reperfused STEMI within 12 h of onset. All patients were equipped with a CGMS when in a stable phase after admission and underwent repeat CMR at baseline and 7 months follow-up. Patients were divided into 2 groups according to the mean amplitude of glycemic excursions (MAGE). Patients in the upper tertile of MAGE were categorized as group High (H) and the other two-thirds as group Low (L). LVR was defined as an absolute increase in left ventricular end-diastolic volume index of ≥20%. LVR more frequently occurred in group H than in group L (56% vs. 11%, P<0.001). Multivariate analysis showed the higher MAGE group was an independent predictor of LVR in the chronic phase (odds ratio, 13.999; 95% confidence interval, 3.059 to 64.056; P=0.001). CONCLUSIONS MAGE early after the onset of STEMI identified patients with LVR in the chronic phase.

GLOBAL LONGITUDINAL STRAIN BY 3D SPECKLE TRACKING AFTER ST-ELEVATION MYOCARDIAL INFARCTION IS USEFUL FOR PREDICTING LEFT VENTRICULAR REMODELING: COMPARISON WITH TC99M-SESTAMIBI

Left ventricular (LV) global strain estimated immediately after ST elevation AMI (STEMI) was reported as a predictor of LV remodeling. We explored the usefulness of global strain estimated by 3D speckle tracking in patients with a first STEMI in comparison with infarct size estimated by Tc99m-

URINARY ALBUMIN EXCRETION PREDICTS RAPID PROGRESSION OF CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME

Rapid Progression (RP) of coronary artery disease(CAD) has been shown to be a powerful predictor of cardiovascular event. However, the predictors of RP are not fully understood in patients with Acute Coronary Syndrome(ACS). On the other hand, albuminuria is well known as a marker of target organ

THE EFFECT OF NIGHTTIME BLOOD PRESSURE VARIABILITY ON LEFT VENTRICULAR HYPERTROPHY AND CAROTID INTIMA MEDIA THICKNESS IN PATIENTS WITH NSTEMI

Although mean nighttime (sleep) blood pressure (BP) and daytime BP variability are important risk factors for target organ damage, the effect of nighttime BP variability was not fully elucidated in patients with non ST-segment elevation acute coronary syndromes (NSTE-ACS). In 25 NSTE-ACS patients

ASSOCIATION BETWEEN HIGHER GLUCOSE VARIABILITY, DETERMINED BY CONTINUOUS GLUCOSE MONITORING SYSTEM, AND POOR CLINICAL CHARACTERISTICS IN STEMI PATIENTS WITH DYSGLYCEMIA, IN COMPARISON WITH CONVENTIONAL GLYCEMIC PARAMETERS

Although glycemic variability is an important component of dysglycemia, its effect on cardiovascular disease was not fully elucidated. The aim of this study was to assess the clinical usefulness of measuring glycemic variability in STEMI patients with dysglycemia (type 2 diabetes mellitus, DM;