Influence of diurnal blood glucose fluctuation on myocardial salvage in acute phase after myocardial infarction and establishment of its treatment

2018 Fiscal Year Final Research Report

• Project/Area Number: 25461063
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Wakayama Medical University
• Principal Investigator: Teraguchi Ikuko 和歌山県立医科大学, 医学部, 博士研究員 (70549782)
• Co-Investigator(Kenkyū-buntansha): 今西 敏雄 和歌山県立医科大学, 医学部, 博士研究員 (00285389)
• Project Period (FY): 2013-04-01 – 2019-03-31
• Keywords: 血糖日内変動 / 急性心筋梗塞 / 心筋救済率 / DPP4阻害剤

Outline of Final Research Achievements

The effect of diurnal blood glucose fluctuation in type 2 diabetes acute myocardial infarction cases acute phase on myocardial salvage and chronic left ventricular remodeling, clarifying the mechanism related to them, and the therapeutic intervention effect by DPP4 inhibitor I have been researching. We announced that "stress hyperglycemia in the acute phase is a factor for myocardial salvage in patients with acute myocardial infarction" and "average blood glucose fluctuation in acute phase is a factor for myocardial salvage in patients with acute myocardial infarction". He also announced that "average blood glucose variability affects coronary plaque rupture". Furthermore, we reported that the myocardial rescue rate is improved through the improvement of blood glucose fluctuation range by the intervention of DPP4 inhibitor, the improvement of peripheral monocyte subsets, and the active glucagon-like peptide 1.

Free Research Field

虚血性心筋障害

Academic Significance and Societal Importance of the Research Achievements

心筋梗塞後の心筋救済率は、慢性期の左室モデリングに悪影響を与え、長期予後に関与する。特に心筋梗塞急性期の高血糖のみならず、血糖日内変動の増大は心筋救済率に悪影響を及ぼすことが明らかとなった。心筋梗塞急性期の血糖変動の増大への治療介入が心筋救済率改善に影響する可能性があるとして、本研究を行ってきた。急性心筋梗塞症例のうち２型糖尿病罹患症例のうち、心筋梗塞発症急性期のビルダグリプチン投与例で有意な血糖変動の平定化が認められ、薬剤介入群では心筋救済率は高いものであった。心筋梗塞発症急性期のビルダグリプチン投与は、急性期血糖変動を平定化させ、心筋救済率に良い影響を与える可能性が示唆された。