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The Role of Acute Hyperglycemia on the Risk of Malignant Arrhythmia in Acute Myocardial Infarction Patients: A Study of Myocardial Damage, Ion Channel Changes and Inflammatory Factors

ACTA MEDICA INDONESIANA · Vol. 52 No. 2 (2020)

ISSN
2338-2732, 0125-9326
Published
2020-08-07
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: acute myocardial infarction (AMI) is often followed by hyperglycemia. To date, there is no study that examine the role of myocardial damage, ion channel changes and increased inflammatory response as a pathomechanism of malignant arrhythmias due to hyperglycemia in AMI patients. The aim of this study is to determine the effect of acute hyperglycemia on the occurence of malignant arrhythmias, troponin I, VLP, echocardiographic strain, ion channel changes (CaMKII) and hsCRP. This study also aims to assess the effect of troponin I, VLP, GLS, CaMKII and hsCRP on the occurence of malignant arrhythmias in AMI patients with acute hyperglycemia. Methods: a cross-sectional study followed by a cohort study was conducted on AMI patients treated at ICCU Cipto Mangunkusumo Hospital Jakarta during November 2018 to May 2019 period. Patients with severe infections and who had experienced malignant arrhythmias at admission were excluded from the study. The occurence of malignant arrhythmias as the main outcome of this study and CaMKII level were assessed on the fifth day of treatment. Patients who died before the fifth day of treatment due to causes other than malignant arrhythmias were excluded from analysis. The association between acute hyperglycemia with VLP and the occurence of malignant arrhythmias was analyzed through a chi-square test, whereas the differences between troponin I, GLS, CaMKII and hsCRP, based on the hyperglycemia status of the patient, were analyzed by Mann-Whitney U test. Results: a total of 110 patients were included in the study. Two patients died on the third day of observation due to malignant arrhythmias. No significant relationship was found between acute hyperglycemia in AMI and malignant arrhythmias (RR = 1,38, 95%CI 0.50−3.77). There were differences of CaMKII level on day-1 and day-5 between those who were experienced malignant arrhytmia and those who were not (p-value for differences are 0,03 and 0,01, respectively. In the acute hyperglycemia group, there was difference of CaMKII day-5 levels between positive and negative VLP (p = 0.03). Conclusion: it was concluded that the inititial stage of AMI causes more dominant myocardial damage, as compared to metabolic factors. In the next stage of AMI, acute hyperglycemia increases ROS and the activation of ion channel changes described by CaMKII. This change results in electrophysiological remodeling of the heart, as seen in the VLP image on SA-ECG.

Keywords

Collaboration network of the authors

40 authors · 289 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Siti SetiatiAffiliation unknown19
Hamzah ShatriAffiliation unknown13
Eka GinanjarAffiliation unknown10
Rudi PutrantoAffiliation unknown9
Suhendro SuwartoAffiliation unknown8
Evy YunihastutiAffiliation unknown7
Aida LydiaAffiliation unknown7
Cleopas Martin RumendeAffiliation unknown7
Muhammad YaminAffiliation unknown6
Em YunirUniversity of Indonesia6
Arif MansjoerAffiliation unknown6
Juferdy KurniawanAffiliation unknown6
Adityo SusiloAffiliation unknown6
Noto DwimartutieAffiliation unknown5
Eka Dian SafitriAffiliation unknown5
Dyah PurnamasariAffiliation unknown5
Andhika RachmanAffiliation unknown5
Ika P WijayaAffiliation unknown5
Cosphiadi IrawanAffiliation unknown5
Roza MulyanaAffiliation unknown4
Rahmi IstantiAffiliation unknown4
Dante Saksono HarbuwonoAffiliation unknown4
Muhadi MuhadiAffiliation unknown4
Birry KarimAffiliation unknown4
Cleopas M RumendeAffiliation unknown4
Simon SalimAffiliation unknown4
Iris RengganisAffiliation unknown4
Dicky Levenus TahaparyAffiliation unknown4
Leonard NainggolanAffiliation unknown3
Lugyanti SukrismanAffiliation unknown3

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">The Role of Acute Hyperglycemia on the Risk of Malignant Arrhythmia in Acute Myocardial Infarction Patients:  A Study of Myocardial Damage, Ion Channel Changes and Inflammatory Factors</dc:title>
	<dc:creator>Nasution, Sally Aman</dc:creator>
	<dc:creator>Alwi, Idrus</dc:creator>
	<dc:creator>Subekti, Imam</dc:creator>
	<dc:creator>Yamin, M</dc:creator>
	<dc:creator>Suhendro, Suhendro</dc:creator>
	<dc:creator>Harimurti, Kuntjoro</dc:creator>
	<dc:creator>Immanuel, Suzanna</dc:creator>
	<dc:creator>Majid, Abdul</dc:creator>
	<dc:creator>Elizabeth, Esther</dc:creator>
	<dc:creator>Azali, Chairul N</dc:creator>
	<dc:subject xml:lang="en-US">acute hyperglycemia</dc:subject>
	<dc:subject xml:lang="en-US">AMI</dc:subject>
	<dc:subject xml:lang="en-US">CaMKII</dc:subject>
	<dc:subject xml:lang="en-US">hsCRP</dc:subject>
	<dc:subject xml:lang="en-US">malignant arrhythmias</dc:subject>
	<dc:subject xml:lang="en-US">VLP</dc:subject>
	<dc:description xml:lang="en-US">Background: acute myocardial infarction (AMI) is often followed by hyperglycemia. To date, there is no study that examine the role of myocardial damage, ion channel changes and increased inflammatory response as a pathomechanism of malignant arrhythmias due to hyperglycemia in AMI patients. The aim of this study is to determine the effect of acute hyperglycemia on the occurence of malignant arrhythmias, troponin I, VLP, echocardiographic strain, ion channel changes (CaMKII) and hsCRP. This study also aims to assess the effect of troponin I, VLP, GLS, CaMKII and hsCRP on the occurence of malignant arrhythmias in AMI patients with acute hyperglycemia. Methods: a cross-sectional study followed by a cohort study was conducted on AMI patients treated at ICCU Cipto Mangunkusumo Hospital Jakarta during November 2018 to May 2019 period. Patients with severe infections and who had experienced malignant arrhythmias at admission were excluded from the study. The occurence of malignant arrhythmias as the main outcome of this study and CaMKII level were assessed on the fifth day of treatment. Patients who died before the fifth day of treatment due to causes other than malignant arrhythmias were excluded from analysis. The association between acute hyperglycemia with VLP and the occurence of malignant arrhythmias was analyzed through a chi-square test, whereas the differences between troponin I, GLS, CaMKII and hsCRP, based on the hyperglycemia status of the patient, were analyzed by Mann-Whitney U test. Results: a total of 110 patients were included in the study. Two patients died on the third day of observation due to malignant arrhythmias. No significant relationship was found between acute hyperglycemia in AMI and malignant arrhythmias (RR = 1,38, 95%CI 0.50−3.77). There were differences of CaMKII level on day-1 and day-5 between those who were experienced malignant arrhytmia and those who were not (p-value for differences are 0,03 and 0,01, respectively. In the acute hyperglycemia group, there was difference of CaMKII day-5 levels between positive and negative VLP (p = 0.03). Conclusion: it was concluded that the inititial stage of AMI causes more dominant myocardial damage, as compared to metabolic factors. In the next stage of AMI, acute hyperglycemia increases ROS and the activation of ion channel changes described by CaMKII. This change results in electrophysiological remodeling of the heart, as seen in the VLP image on SA-ECG.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2020-08-07</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/1285</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 52 No. 2 (2020): Acta Medica Indonesiana; 102</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/1285/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2020 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>