Hiperglicemia de estresse na sindrome coronariana aguda: controle e importância prognóstica: [revisão]

A insuficiencia cardiaca e atualmente uma importante complicacao das sindromes coronarianas agudas, e agrava de forma consideravel o prognostico intra e extrahospitalar. A presenca da diabetes melito e classicamente un fator de risco para desenvolvimento de infarto agudo do miocardio e insuficiencia cardiaca, sendo um problema de alta prevalencia com crescimento epidemico na populacao mundial. A hiperglicemia de estresse esta presente ente 25 a 50 por cento dos pacientes admitidos com sindrome coronariana aguda e associam-se ao risco de complicacoes, intra-hospitalares tanto em pacientes com e sem diabetes melito, sendo marcador de pior prognostico para mortalidade, IC e choque cardiogenico. A abordagem terapeutica da hiperglicemia de estresse na sindrome coronaria aguda e ainda controversa, nao havendo consenso sobre o melhor metodo de mensuracaoglicemica assim como o melhor tipo de tratamento. O objetivo deste artigo e revisar o estado da arte entre aassociacao da hiperglicemia de estresse e a incidencia de insuficiencia cardiaca apos a sindrome coronariana aguda.(AU) Heart failure is currently an important complication of acute coronary syndromes, with significantly poorerprognoses, both in and out of hospital. The presence of diabetes mellitus is classically a risk factor for thedevelopment of acute myocardial infarction and heart failure, constituting a highly prevalent problem that isexpanding like an epidemic through the world’s population. Stress hyperglycemia is present in 25% to 50% of patients admitted with acute coronary syndrome,associated with the risk of in-hospital complications for patients with and without diabetes mellitus, being amarker for poor prognosis in terms of death, heart failure and cardiogenic shock. The therapeutic approach to stress hyperglycemia in acute coronary syndrome is still controversial, with no consensus on the best glucosemeasurement method nor the best type of treatment. The purpose of this paper is to review the state of the art of the association between stress hyperglycemia and the incidence of heart failure after acute coronary syndrome.(AU)