Hyperglycemia and ACS: Effects on Myocardial Energetics and Blood Flow

Presented By:		Ori Ben-Yehuda, MD, FACC Professor of Medicine University of California, San Diego Director, Coronary Care Unit University of California, San Diego Medical Center La Jolla, California

Program Description:	This CME activity consists of an educational component (ie, slides, audio lecture, newsletter) in an electronic format, followed by an online post-test. Estimated time to complete this activity, including review of materials, is 1 hour.
General Information:	Requirements for Successful Completion: This CME activity consists of an educational component (ie, slides, audio lecture, newsletter) in an electronic format, which is followed by an online post-test. There is no fee to participate in this CME activity or to receive CME credit. Certificates are awarded upon successful completion (80% proficiency) of the post-test. In order to receive credit, participants must view the presentaion in its entirety. Media: Internet Release Date:    August 20, 2008 Expiration Date:  August 19, 2010
Target Audience:	Clinical Cardiologists, Endocrinologists, Internal Medicine Physicians, Lipidologists
Program Overview:	The incidence of diabetes or impaired fasting glucose (IFG) is common in patients with coronary artery disease. Hyperglycemia causes a cascade of negative effects on metabolic systems, which can lengthen hospital stay and complicate disease. A 50% increase in the risk of mortality is seen in patients with impaired glucose metabolism, especially after acute myocardial infarction (AMI). Fluctuations in glucose after admission to the hospital for AMI adversely affect molecular pathways, inflammatory markers, and endothelial function, and may lead to oxidative stress. New-onset hyperglycemia is associated with the highest rate of in-hospital mortality; glucose measurements upon hospital admission post AMI are potent predictors of both 30-day and 1-year mortality, regardless of diabetes status. Blood glucose levels as modest as =110 mg/dL are associated with an increase in the risk of mortality, as well as higher levels of free fatty acids in the blood stream and a weakened immune system. The effects of hyperglycemia can have deleterious outcomes, reinforcing the need for prompt and diligent in-hospital protocols that focus on maintaining euglycemia.
Learning Objectives:	•Recognize the importance of testing glucose levels within the first 24 hours after hospital admission for all patient populations to minimize long-term cardiovascular consequences •Understand the multiple detrimental vascular effects of hyperglycemia in order to improve treatments and optimize overall patient care •Recognize the need to implement immediate in-hospital protocols to maintain euglycemia
Faculty Disclosure:	The University of Florida College of Medicine has a conflict of interest policy that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. It is not assumed that these financial interests or affiliations will have an adverse impact on faculty presentations; they simply are noted here to fully inform participants. Ori Ben-Yehuda, MD, has indicated that he has a financial arrangement or affiliation with sanofi-aventis. The types of affiliations/financial interests are grant/research support and honoraria.
Continuing Medical Education Credit:
	Accreditation
	The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
	Credit
	The University of Florida College of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
	This continuing education activity was planned in accordance with the ACCME essentials and reviewed by Carl J. Pepine, MD, Program Chair.
	Click here for disclosure and disclaimer information
Commercial Support:	This CME activity is supported by an educational grant from sanofi-aventis.
System Requirements:	In order to view the presentation, your computer must have a media player such as Windows Media Player, Quicktime, or RealOne.
CME Contact:	For any question regarding this Internet CME activity, please contact the Office of Continuing Medical Education at 352-265-8081.
	The University of Florida College of Medicine has received permission to use this copyrighted material within a CME activity on the internet.

Take this presentation with you:
Download this Online Lecture as an MP3 and load it onto your iPod or other portable audio player.
MP3 Audio File
(Right-click and select "Save Target As..." to download)