Hyperglycemia and outcome after myocardial infarction and cardiac surgery: so what?

Hyperglycemia is a frequent observation during acute illness such as myocardial infarction and after major surgery. The proportion of patients with hyperglycemia may be as high as 95% to 100% after cardiac surgery. This stress-induced hyperglycemia has a detrimental effect on outcome after myocardial infarction and cardiac surgery. Mortality may increase by a factor of 4, especially in non-diabetic patients. Control of hyperglycemia to normalize blood glucose is associated with a clear clinical benefit. This effect is most beneficial in nondiabetic patients with hyperglycemia. The exact target level of glycemia is still a matter of investigation, but normalization to values between 80 and 125 mg/dL is probably optimal.