Anti-inflammatory effects of insulin and pro-inflammatory effects of glucose: relevance to the management of acute myocardial infarction and other acute coronary syndromes

Paresh Dandona; Ajay Chaudhuri; Husam Ghanim; Priya Mohanty

Anti-inflammatory effects of insulin and pro-inflammatory effects of glucose: relevance to the management of acute myocardial infarction and other acute coronary syndromes

Rev Cardiovasc Med. 2006:7 Suppl 2:S25-34.

Authors

Paresh Dandona¹, Ajay Chaudhuri, Husam Ghanim, Priya Mohanty

Affiliation

¹ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA.

PMID: 17224874

Abstract

Hyperglycemia worsens morbidity and mortality for patients in intensive care or with acute myocardial infarction, stroke, or coronary artery bypass grafts. The control of hyperglycemia with insulin improves clinical outcomes for patients with these conditions. This article reviews the anti-inflammatory effects of insulin and pro-inflammatory effects of glucose and free fatty acids, and provides a mechanistic justification for maintaining euglycemia with insulin infusions. Hyperglycemia induced by infusions of a fixed dose of insulin with high rates of glucose may neutralize the benefit of insulin, and such regimens should be replaced by infusion of insulin to restore and maintain euglycemia.

Publication types

Review

MeSH terms

Acute Coronary Syndrome / complications
Acute Coronary Syndrome / drug therapy*
Acute Coronary Syndrome / metabolism
Acute Coronary Syndrome / mortality
Animals
Anti-Inflammatory Agents / administration & dosage
Anti-Inflammatory Agents / therapeutic use*
Atherosclerosis / drug therapy
Atherosclerosis / metabolism
Blood Glucose / drug effects
Blood Glucose / metabolism*
Coronary Artery Bypass / adverse effects
Disease Models, Animal
Drug Administration Schedule
Fatty Acids, Nonesterified / metabolism
Glucose / administration & dosage
Glucose / adverse effects
Humans
Hyperglycemia / complications
Hyperglycemia / drug therapy*
Hyperglycemia / metabolism
Hyperglycemia / mortality
Hypoglycemic Agents / administration & dosage
Hypoglycemic Agents / therapeutic use*
Inflammation / drug therapy*
Inflammation / etiology
Inflammation / metabolism
Inflammation / mortality
Infusions, Parenteral
Insulin / administration & dosage
Insulin / adverse effects
Insulin / therapeutic use*
Myocardial Infarction / complications
Myocardial Infarction / drug therapy*
Myocardial Infarction / metabolism
Myocardial Infarction / mortality
Obesity / complications
Obesity / metabolism
Potassium / administration & dosage
Potassium / adverse effects
Reactive Oxygen Species / metabolism
Risk Assessment
Risk Factors
Treatment Outcome

Substances

Anti-Inflammatory Agents
Blood Glucose
Fatty Acids, Nonesterified
Hypoglycemic Agents
Insulin
Reactive Oxygen Species
glucose-insulin-potassium cardioplegic solution
Glucose
Potassium