Reply to Huang
We thank Dr Huang and coworkers for their interest in our article comparing the predictive value of admission glucose in the invasive versus the preinvasive era.
Unfortunately, we have no data on the specific diabetic medication used by the patients. Therefore, it is hard to assess how this influenced glycemic control and clinical outcomes. We would like to add that it is important to identify two different intensive strategies: one in the clinical phase during admission for a myocardial infarction and the other in an outpatient setting. As illustrated in our article, conflicting evidence exists regarding the first. Therefore, we currently try to clarify this matter in a randomized clinical trial; BIOMArCS 2 glucose. In a more stable outpatient setting, reviews indeed suggest a beneficial effect of intensive glucose regulation.
Finally, we would like to emphasize that it is essential to screen (hyperglycemic) myocardial infarction patients for previously undiagnosed diabetes, as this occurs in up to 31% when tested with an oral glucose tolerance test. This early detection allows early lifestyle and medical measures.
|Persistent URL||dx.doi.org/10.1016/j.ahj.2010.10.020, hdl.handle.net/1765/33557|
|Journal||American Heart Journal|
de Mulder, M, Cornel, J.-H, van der Ploeg, T, Boersma, H, & Umans, V.A.W.M. (2011). Reply to Huang. American Heart Journal, 161(1). doi:10.1016/j.ahj.2010.10.020