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Comment & Response
May 2014

Intensive Glucose Control for Acute Myocardial Infarction—Reply

Author Affiliations
  • 1Department of Cardiology, Medical Center Alkmaar, Alkmaar, the Netherlands
  • 2Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands
JAMA Intern Med. 2014;174(5):826-827. doi:10.1001/jamainternmed.2014.343

In Reply We appreciate the interest of Sardar et al in our randomized clinical trial on intensive glucose regulation in patients with acute coronary syndrome with elevated blood glucose level on admission. They raise several relevant issues.

An explanation, other than random chance, for the observed 12-minute difference in median time from admission to randomization could be sought in the admission diagnosis. Non–ST-segment elevation myocardial infarction (NSTEMI) was more common in the patients randomized to intensive vs conventional glucose management (21.4% vs 15.0%). For patients with NSTEMI, elevated troponin level was a prerequisite for enrollment. Hence, laboratory results should be awaited, which delayed inclusion by approximately 1 hour.

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