Impact of Tight Glycaemic Control in Acute Myocardial Infarction

Melbourne Health

Status and phase: Terminated; Phase 4

Conditions: Myocardial Infarct; Hyperglycemia

Treatments: Drug: Insulin (tight blood glucose control)

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT00237471

GEENA

2004.116

Details and patient eligibility

About

To determine whether tight glycaemic control with insulin improves myocardial function and myocardial perfusion (measured by myocardial contrast echocardiography) and novel vascular risk factors in patients with acute myocardial infarction and hyperglycaemia.

Full description

We will randomise patients with acute myocardial infarction and blood glucose levels (BGLs) >=10mmol/L within 24 hours of pain onset, to either tight glucose control (aiming BGLs 4.5 - 7mmol/L) with an insulin infusion (for 24 hours) followed by subcutaneous insulin or standard control (BGL 6 - 12mmol/L) without the use of an insulin infusion. Serial myocardial contrast echocardiography will measure changes in myocardial perfusion and function from baseline to 3 months between each group. We will also measure changes in inflammatory and endothelial markers over this time to see whether tight glucose control improves these surrogate endpoints.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age >=18years
• Acute Myocardial Infarction
• Blood Glucose Level >=10mmol/L
• Wall motion abnormality on baseline echocardiogram

Exclusion criteria

• Active infection/inflammation
• Cardiac shunt
• Cognitive Impairment
• Insulin allergy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)