Predictive Value of Glycemic Parameters Measured With the FSL Pro iQ During ACS
- Conditions
- Continuous Glucose MeasurementAcute Coronary SyndromeGlycemic VariabilityCardiovascular Event
- Interventions
- Device: Freestyle Libre Pro iQ
- Registration Number
- NCT06014112
- Lead Sponsor
- University Hospital, Montpellier
- Brief Summary
Disorders of glycemic regulation are common in patients hospitalized for acute coronary syndrome (ACS). Abnormal glycaemia is observed in 50% of cases, in 30-40% diabetes, and in 25-35% fasting hyperglycaemia or glucose intolerance.
Hyperglycemia is a major prognostic factor in ACS, with admission hyperglycemia having independent prognostic value for both short- and long-term major cardiovascular events (MACE), regardless of the presence of diabetes.
Metabolically, several situations can be distinguished:
* Hyperglycaemia occurs in known non-diabetic ACS subjects. It can be indicative of (i) Type 2 Diabetes or (ii) stress hyperglycaemia (diagnostic threshold for blood sugar varies according to learned societies, with HbA1c \< 6.5%).
* Hyperglycaemia occurs in known diabetic ACS subjects Most studies use admission blood sugar as a predictor. However, it has recently been shown that glycemic variability indexes would be better predictors of MACE. Using continuous glucose measurement for 48 h, it has been shown that significant glycemic variability is a more powerful predictor of MACE at 1 year than admission glycemia The measurement of glycemic variability is mainly possible thanks to the development of CGM (continuous glucose measurement).
To our knowledge, no study has been interested in evaluating the predictive value of the various glycemic parameters measured by CGM.
Published studies have used continuous glucose measurements for very short periods (24 or 72 hours maximum), which limits these measurements.
The freestyle libre Pro iQ (FSLPro iQ) is a professional sensor for continuous, non-invasive interstitial glucose measurement allowing the recording of glycemic parameters for 2 weeks.
Our hypothesis is that glycaemic parameters, alone or in combination with each other or with other patient risk factors, measured with the Freestyle libre Pro iQ have a significant prognostic value in terms of cardiovascular clinical events at 12 months in a population of patients with ACS managed as standard and followed up.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 850
- Patients with ACS managed in a cardiac intensive care unit (ICU). The diagnosis of ACS will be made in the presence of chest pain with ST-segment elevation on the ECG for STEMI or ST-segment change and/or a positive troponin cycle (values in accordance with the center's protocol) for NSTEMI.
- Subjects in cardiogenic or septic shock
- Subjects with ACS initially managed in a non-investigating center
- Failure to obtain free, informed, written consent signed by the participant and investigator upon admission to the ICU
- Person participating in another research study with an ongoing exclusion period
- Subjects participating in a study that may have an impact on post ACS prognosis
- Person deprived of his or her rights, person under guardianship or curatorship
- Person deprived of liberty (by judicial or administrative decision)
- Persons whose physical and/or psychological health is severely impaired, which, in the opinion of the investigator, may affect the participant's compliance to the study
- Pregnant or breastfeeding women
- Person who is not affiliated to a social security system or who is a beneficiary of such a system.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Freestyle Libre PRO iQ sensor Freestyle Libre Pro iQ Eligible patients
- Primary Outcome Measures
Name Time Method Cardiovascular events 12 months Occurrence within 12 months of hospital discharge of a composite end point including cardiovascular clinical events: recurrent MI, cardiovascular death, stroke, rhythm disturbance, and/or heart failure requiring hospitalization.
- Secondary Outcome Measures
Name Time Method Diabetes 2 months Incidence of diabetes at 1-2 months in nondiabetic subjects admitted for ACS: fasting venous glucose measurement (≥ 1.26g/L) and HbA1c (≥ 6.5%).
Trial Locations
- Locations (7)
University Hospital of Nîmes
🇫🇷Nîmes, France
University Hospital of Toulouse
🇫🇷Toulouse, France
AP-HP Lariboisière Hospital
🇫🇷Paris, France
University Hospital of Bordeaux
🇫🇷Bordeaux, France
Hospital of Béziers
🇫🇷Béziers, France
University Hospital of Montpellier
🇫🇷Montpellier, France
Hospital of Pau
🇫🇷Pau, France