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COMMENTS AND OPINIONS
Is Insulin the Preferred Compound in Lowering Glucose Levels in Patients After a Myocardial Infarction?—Reply
Mikhail Kosiborod, MD;
Silvio E. Inzucchi, MD;
Harlan M. Krumholz, MD, SM;
Frederick A. Masoudi, MD, MSPH;
Abhinav Goyal, MD, MHS;
John A. Spertus, MD, MPH
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In reply
Rensing and colleagues raise an important question in regard to insulin therapy among hyperglycemic patients hospitalized for AMI. Based on the statistically insignificant but quantitatively higher in-hospital mortality across several of our predefined mean glucose categories,1 they suggest that insulin may be associated with increased mortality risk.
While not the main objective of our study (which was to evaluate whether normalization of glucose levels is associated with better survival), the impact of insulin therapy on patient outcomes in a setting of AMI is an important and controversial issue. While treatment thresholds and therapeutic goals remain subjects of intense debate, professional societies currently endorse glucose control in patients with AMI and significant hyperglycemia (blood glucose level >180 mg/dL [to convert to millimoles per . . . [Full Text of this Article]
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RELATED ARTICLE
Glucose Normalization and Outcomes in Patients With Acute Myocardial Infarction
Mikhail Kosiborod, Silvio E. Inzucchi, Harlan M. Krumholz, Frederick A. Masoudi, Abhinav Goyal, Lan Xiao, Philip G. Jones, Suzanne Fiske, and John A. Spertus
Arch Intern Med. 2009;169(5):438-446.
ABSTRACT
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RELATED LETTER
Is Insulin the Preferred Compound in Lowering Glucose Levels in Patients After a Myocardial Infarction?
Katrijn L. Rensing, John J. P. Kastelein, and Marcel Twickler
Arch Intern Med. 2009;169(17):1636-1637.
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