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Review

Stress-Induced Hyperglycaemia in Non-Diabetic Patients with Acute Coronary Syndrome: From Molecular Mechanisms to New Therapeutic Perspectives

1
Unità Operativa Complessa Cardiologia con UTIC ed Emodinamica-Dipartimento Emergenza Accettazione, Azienda Ospedaliera “Antonio Cardarelli”, 80131 Napoli, Italy
2
Dipartimento di Scienze Biomediche Avanzate, Università Federico II, 80131 Napoli, Italy
3
Department of Cardiovascular and Metabolic Diseases, IRCCS Multimedica, Sesto San Giovanni, 20099 Milan, Italy
4
Dipartimento di Scienze Mediche Traslazionali, Università Federico II, 80131 Napoli, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(2), 775; https://doi.org/10.3390/ijms22020775
Received: 10 December 2020 / Revised: 8 January 2021 / Accepted: 10 January 2021 / Published: 14 January 2021
Stress-induced hyperglycaemia (SIH) at hospital admission for acute coronary syndrome is associated with poor outcome, especially in patients without known diabetes. Nevertheless, insulin treatment in these subjects was not correlated with the reduction of mortality. This is likely due to the fact that SIH in the context of an acute coronary syndrome, compared to that in known diabetes, represents an epiphenomenon of other pathological conditions, such as adrenergic and renin-angiotensin system over-activity, hyperglucagonaemia, increase of circulating free fatty acids and pancreatic beta-cell dysfunction, which are not completely reversed by insulin therapy and so worsen the prognosis. Thus, SIH may be considered not only as a biomarker of organ damage, but also as an indicator of a more complex therapeutic strategy in these subjects. The aim of this review is to analyse the molecular mechanisms by which SIH may favour a worse prognosis in non-diabetic patients with acute coronary syndrome and identify new therapeutic strategies, in addition to insulin therapy, for a more appropriate treatment and improved outcomes. View Full-Text
Keywords: stress-induced hyperglycaemia; acute coronary syndrome; non-diabetic patient; insulin; GLP-1 receptor agonist; DPP-4 inhibitors; glifozins; multitargeted therapeutic strategy stress-induced hyperglycaemia; acute coronary syndrome; non-diabetic patient; insulin; GLP-1 receptor agonist; DPP-4 inhibitors; glifozins; multitargeted therapeutic strategy
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MDPI and ACS Style

Bellis, A.; Mauro, C.; Barbato, E.; Ceriello, A.; Cittadini, A.; Morisco, C. Stress-Induced Hyperglycaemia in Non-Diabetic Patients with Acute Coronary Syndrome: From Molecular Mechanisms to New Therapeutic Perspectives. Int. J. Mol. Sci. 2021, 22, 775. https://doi.org/10.3390/ijms22020775

AMA Style

Bellis A, Mauro C, Barbato E, Ceriello A, Cittadini A, Morisco C. Stress-Induced Hyperglycaemia in Non-Diabetic Patients with Acute Coronary Syndrome: From Molecular Mechanisms to New Therapeutic Perspectives. International Journal of Molecular Sciences. 2021; 22(2):775. https://doi.org/10.3390/ijms22020775

Chicago/Turabian Style

Bellis, Alessandro, Ciro Mauro, Emanuele Barbato, Antonio Ceriello, Antonio Cittadini, and Carmine Morisco. 2021. "Stress-Induced Hyperglycaemia in Non-Diabetic Patients with Acute Coronary Syndrome: From Molecular Mechanisms to New Therapeutic Perspectives" International Journal of Molecular Sciences 22, no. 2: 775. https://doi.org/10.3390/ijms22020775

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