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dc.contributor.authorNam, MCY
dc.contributor.authorByrne, CD
dc.contributor.authorKaski, JC
dc.contributor.authorGreaves, K
dc.date.accessioned2023-06-08T22:50:43Z
dc.date.available2023-06-08T22:50:43Z
dc.date.issued2016
dc.identifier.issn0920-3206en_US
dc.identifier.doi10.1007/s10557-016-6679-9en_US
dc.identifier.urihttp://hdl.handle.net/10072/407718
dc.description.abstractThe role of insulin in the treatment of acute coronary syndrome (ACS) has been widely studied over the past 100 years. The current indication for its use in this context is the treatment of hyperglycemia, irrespective of diabetes, which is associated with adverse outcome. Initial theories proposed that glucose was beneficial in the context of myocardial ischemia and insulin was required to enable glucose cell uptake. However, studies testing this hypothesis with routine insulin administration during ACS have produced disappointing results and research interest has therefore declined. We propose that the less well known but important vasodilator effect of insulin has been overlooked by some of these studies and warrants further consideration. Previous reports have shown that hyperinsulinemic euglycaemia improves myocardial blood flow reserve. With this in mind, this review considers the role of insulin in the context of ACS from the perspective of a vasodilator rather than a metabolic modulator. We discuss the importance of time to treatment, dosage of insulin administered, problems with hypoglycaemia and insulin resistance, and how they may have affected the outcomes of the major trials. Finally, we propose new study designs that allow determination of the optimal vasodilator conditions for the use of insulin as adjunctive pharmacotherapy during myocardial ischaemia.en_US
dc.description.peerreviewedYesen_US
dc.languageengen_US
dc.publisherSpringeren_US
dc.relation.ispartofpagefrom493en_US
dc.relation.ispartofpageto504en_US
dc.relation.ispartofissue5en_US
dc.relation.ispartofjournalCardiovascular Drugs and Therapyen_US
dc.relation.ispartofvolume30en_US
dc.subject.fieldofresearchPharmacology and pharmaceutical sciencesen_US
dc.subject.fieldofresearchcode3214en_US
dc.subject.keywordsAcute coronary syndromeen_US
dc.subject.keywordsCoronary artery diseaseen_US
dc.subject.keywordsInsulinen_US
dc.subject.keywordsMyocardial blood flow reserveen_US
dc.titleInsulin in acute coronary syndrome: A narrative review with contemporary perspectivesen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationNam, MCY; Byrne, CD; Kaski, JC; Greaves, K, Insulin in acute coronary syndrome: A narrative review with contemporary perspectives, Cardiovascular Drugs and Therapy, 2016, 30 (5), pp. 493-504en_US
dc.date.updated2021-09-07T05:56:49Z
dc.description.versionAccepted Manuscript (AM)en_US
gro.rights.copyright© 2016 Springer. This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s10557-016-6679-9en_US
gro.hasfulltextFull Text
gro.griffith.authorGreaves, Kim


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