Tight glycemic control may increase regenerative potential of myocardium during acute infarction.

Aims: We analyzed the effects of tight glycemic control on regenerative potential of myocardium during acute myocardial infarction. Patients and Methods: Seventy-five patients with their first acute myocardial infarction undergoing coronary bypass surgery were studied: 25 patients with glycemia below 140 mg/dl served as the control group; hyperglycemic patients (glucose >140 mg/dl) were randomized to intensive glycemic control (IGC; n = 20; glucose goal, 80–140 mg/dl), conventional glycemic control (CGC; n = 20; glucose goal, 180–200 mg/dl), or glucose-insulin-potassium (GIK; n = 10; glucose goal, 180–200 mg/dl) for almost 3 d before surgery, using insulin infusion followed by sc insulin treatment. During surgery, myocyte precursor cells (MPC) (c-kit/MEFC2/GATA4-positive cells), oxidation of MPC DNA (c-kit/8-hydroxydeoxyguanosine-positive cells), senescent MPC (c-kit/p16INK4a-positive cells), and cycling cardiomyocytes (Ki-67-positive cells) were analyzed in biopsy specimens taken from the peri-infarcted ...