None of the trials examined the effects of the interventions in terms of costs .
AUTHORS ' CONCLUSIONS The included trials did not demonstrate significant differences for most of the outcomes when targeting intensive perioperative glycaemic control compared with conventional glycaemic control in patients with diabetes mellitus .
However , posthoc analysis indicated that intensive glycaemic control was associated with an increased number of patients experiencing hypoglycaemic episodes .
BACKGROUND Patients with diabetes mellitus are at increased risk of postoperative complications .
Data from r and omised clinical trials and meta-analyses point to a potential benefit of intensive glycaemic control , targeting near-normal blood glucose , in patients with hyperglycaemia ( with and without diabetes mellitus ) being su bmi tted to surgical procedures .
However , there is limited evidence concerning this question in patients with diabetes mellitus undergoing surgery .
OBJECTIVES To assess the effects of perioperative glycaemic control for diabetic patients undergoing surgery .
A randomized trial comparing myocardial salvage achieved by coronary stenting versus balloon angioplasty in patients with acute myocardial infarction considered ineligible for reperfusion therapy.
OBJECTIVES We assessed myocardial salvage achieved by reperfusion with percutaneous coronary interventions ( PCI ) and compared stenting with balloon angioplasty ( PTCA ) in patients with acute myocardial infa rct ion ( AMI ) ineligible for thrombolysis . BACKGROUND A substantial proportion of patients with AMI are currently considered ineligible for thrombolysis , and reperfusion treatment is frequently not recommended for them . It is not known whether these patients benefit from PCI . METHODS The Stent or PTCA for Occluded Coronary Arteries in Patients with Acute Myocardial Infa rct ion Ineligible for Thrombolysis ( STOPAMI-3 ) trial , a r and omized , open-label study , included 611 patients with AMI who were ineligible for thrombolysis ( lack of ST-segment elevation on the electrocardiogram , late presentation > 12 h after symptom onset , and contraindications to thrombolysis ) . Patients were r and omly assigned to receive either coronary artery stenting ( n = 305 ) or PTCA ( n = 306 ) . Scintigraphic myocardial salvage index ( proportion of the initial myocardial perfusion defect that was salvaged by reperfusion ) was the primary end point of the study . RESULTS A considerable myocardial salvage was achieved with both stenting and PTCA . In patients assigned to receive stenting , the median size of the salvage index was 0.54 ( 25th and 75th percentiles , 0.29 and 0.87 ) , as compared with a median of 0.50 ( 25th and 75th percentiles , 0.26 and 0.82 ) in the group assigned to receive PTCA ( p = 0.20 ) . Mortality at six months was 8.2 % in the group of patients assigned to receive stenting and 9.2 % in the group of patients assigned to receive PTCA ( p = 0.69 ) . CONCLUSIONS Patients with AMI who are currently considered ineligible for thrombolysis by conventional guidelines may greatly benefit from primary PCI . The benefit seems to be comparable when a strategy of stenting is compared with a strategy of PTCA in these patients
None of the trials examined the effects of the interventions in terms of costs .
AUTHORS ' CONCLUSIONS The included trials did not demonstrate significant differences for most of the outcomes when targeting intensive perioperative glycaemic control compared with conventional glycaemic control in patients with diabetes mellitus .
However , posthoc analysis indicated that intensive glycaemic control was associated with an increased number of patients experiencing hypoglycaemic episodes .
BACKGROUND Patients with diabetes mellitus are at increased risk of postoperative complications .
Data from r and omised clinical trials and meta-analyses point to a potential benefit of intensive glycaemic control , targeting near-normal blood glucose , in patients with hyperglycaemia ( with and without diabetes mellitus ) being su bmi tted to surgical procedures .
However , there is limited evidence concerning this question in patients with diabetes mellitus undergoing surgery .
OBJECTIVES To assess the effects of perioperative glycaemic control for diabetic patients undergoing surgery .