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Background: Acute hyperglycemia in patients with myocardial infarction is an unfavorable predictive factor. However, there are limited data regarding the relationship between acute hyperglycemia and the incidence of new onsets diabetes in long-term observation., Aim: We studied the relationship between admission glycemia in patients with myocardial infarction and the future development of diabetes., Methods: In 190 patients admitted during 2004-2007 years with myocardial infarction diabetes was excluded on the basis of oral glucose tolerance test (OGTT) performed at the end of hospitalization. Patients were divided into three groups according to admission glucose level: G1 <7.8 mmol/l (<140 mg/dl); G2: 7.8-11.0 mmol/l (140-199 mg/dl); G3 ≥11.1 mmol/l (≥200 mg/dl)., Results: The groups consisted of 80 (42.1%), 94 (49.5%) and 16 (8.4%) patients, respectively for G1, G2 and G3. The mean age was 61.3±11.3 years. ST-segment elevation myocardial infarction (STEMI) was diagnosed in 158 patients (83.2%) and non-ST-segment elevation myocardial infarction (NSTEMI) in 32 patients (16.8%). A total of 15 cases (7.9% of the study group) of newly diagnosed diabetes mellitus were registered during a mean follow-up of 48.2±13.9 months. Higher incidence of new diabetes diagnosis was noticed in patients with higher glucose level on admission (5.0% vs. 7.4% vs. 25.0%, p=0.0249). Regression analysis showed two independent risk factors of diabetes development in observational period: admission glucose level considered as continuous variable with OR 1.2 (95% CI 1.0-1.4, p=0.03) and occurrence of IGT with OR 3.6 (95% CI 1.0-12.0, p=0.04)., Conclusions: Patients with acute hyperglycemia during myocardial infarction are more likely to have diabetes in future. This group of patients requires a close monitoring of glucose metabolism after myocardial infarction.

Correlation of the thickness of the left ventricular posterior wall (LVPWd) with various parameters, including age, gender, weight and height, was investigated in this study using regression models. Multicenter derived database comprised over 4,000 healthy individuals. The developed models were further utilized in the in vitro-in vivo (IVIV) translation of the drug cardiac safety data with use of the mathematical model of human cardiomyocytes operating at the virtual healthy population level. LVPWd was assumed to be equivalent to the length of one-dimensional string of virtual cardiomyocyte cells which was presented, as other physiological factors, to be a parameter influencing the simulated pseudo-ECG (pseudoelectrocardiogram), QTcF and ∆QTcF, both native and modified by exemplar drug (disopyramide) after I Kr current disruption. Simulation results support positive correlation between the LVPWd and QTcF/∆QTc. Developed models allow more detailed description of the virtual population and thus inter-individual variability influence on the drug cardiac safety.

Myocardial infarction (MI) is most commonly caused by atherosclerosis and/or inflammatory processes of coronary artery walls. The consequence of those phenomena is instability of the atherosclerotic plaque, activation of the coagulation cascade and thrombus formation which occludes the lumen of the vessel. Vasospasm and microembolisation may participate in MI pathogenesis. In young individuals with diagnosis of MI, coronarography often reveals no pathologies. Is reported that MIs without significant changes of the coronary arteries occur in 1% to 12% of patients. In this article we focus on chemical substances, medicines among them, which can be a cause of MI.

Background: Acute hyperglycaemia is an adverse prognostic factor in patients with acute coronary syndrome (ACS). It is unclear whether these negative effects apply equally to patients with diabetes mellitus (DM) and non-DM patients., Aim: To evaluate the short-term (in-hospital) and long-term (four-year) prognostic value of acute hyperglycaemia in ACS patients with or without DM., Methods: The study involved 116 ACS patients admitted between 2004 and 2006 to our department, who were selected for invasive treatment and who had both admission and first fasting glucose levels measured. Patients were classified as DM (n = 23), on the basis of a known history of diabetes or newly detected diabetes, or non-DM (n = 93). Acute hyperglycaemia was defined as an admission glycaemia ≥ 10.0 mmol/L (180 mg/dL) for non-DM patients, or ≥ 7.8 mmol/L (140 mg/dL) for DM patients, or a first fasting glucose level ≥ 5.6 mmol/L (100 mg/dL) for both DM and non-DM patients. The primary end-point was defined as mortality during follow-up. The secondary end-points were death, cardiac arrest or repeated ACS occurrence, stroke or transient ischaemic attack, and the need for repeat percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) procedure during the in-hospital and four-year post-hospital periods. During follow-up, patients were assessed for a composite end-point defined as all-cause death, repeated ACS occurrence, repeat PCI or CABG procedure, and stroke., Results: Acute hyperglycaemia was present in 28 non-DM and 14 DM patients. The mean follow-up time was 4 ± 0.6 years. For DM patients, there was no significant difference in four-year mortality between hyperglycaemic and normoglycaemic patients (14.3% vs 11.1%, respectively; NS). The occurrence of secondary end-points and composite end-point frequency was also similar for these subgroups, both for in-hospital and four-year observations. For non-DM patients, the four-year mortality was similar for hyperglycaemic and normoglycaemic subjects (17.9% vs 10.8%, respectively; NS), whereas cardiac arrest during the in-hospital period was more common for hyperglycaemic than normoglycaemic patients (3.6% vs 0.0%, respectively; n = 1 vs 0; p = 0.01). The composite end-point for the in-hospital period was reached by 17.6% of hyperglycaemic and 13.8% of normoglycaemic non-DM patients (NS). The composite end-point during the four-year observation period was more frequently reached in hyperglycaemic than in normoglycaemic non-DM patients (78.6% vs 56.9%, respectively; p = 0.04)., Conclusions: Acute hyperglycaemia in non-DM patients hospitalised due to ACS was found to be an unfavourable long-term (four-year) risk factor, and may also be an unfavourable in-hospital risk factor. In contrast, acute hyperglycaemia did not affect cardiovascular outcomes in DM patients.