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Abstract Glycemic status is an important risk factor affecting outcome in subjects with acute coronary syndrome (Malmberg K et al, 1999). Subjects with diabetes mellitus have an increased case fatality after an acute myocardial infarction as compared with non diabetic subjects (Behar S et al, 1997). Furthermore, hyperglycemia after an acute myocardial infarction is associated with an increased risk of in-hospital death in patients without known diabetes (Norhammar AM et al, 1999, Bolk J et al, 2001). In a meta-analysis of studies in the pre-thrombolytic it was shown that non diabetic patients with hyperglycemia at the time of acute myocardial infarction had a 4 fold increase in fatal outcome and a 3 fold higher risk for congestive heart failure or cardiogenic shock (Capes SE et al, 2000). Among patients with no prior history of diabetes, hyperglycemia may reflect previously undiagnosed diabetes, pre-existing impaired glucose tolerance, stress induced hyperglycemia or combination of these (Ceriello A, 2005). Insulin and glucose administration in hyperglycemic patients with acute myocardial infarction improves the outcome (Malmberg K et al, 1999). |