Submited on: 02 Dec 2011 04:47:35 PM GMT
Published on: 02 Dec 2011 06:37:18 PM GMT

  • What are the main claims of the paper and how important are they?

    The paper claims that stress induced hyperglycemia leads to a higher number of adverse cardiovascular events in patients hospitalized with acute myocardial infarction.

  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No, these claims are not novel. There are a number of papers published with the same claims. A few citations are listed below.


    Ceriello, Antonio. "Acute Hyperglycaemia: A ‘new’ Risk Factor during Myocardial Infarction." European Heart Journal 26 (2005): 328-31. Web.

    Chakrabarti, Anjan K., Priyamvada Singh, Lakshmi Gopalakrishnan, Varun Kumar, Meagan Elizabeth Doherty, Cassandra Abueg, Weici Wang, and C. Michael Gibson. "Admission Hyperglycemia and Acute Myocardial Infarction: Outcomes and Potential Therapies for Diabetics and Nondiabetics." Cardiology Research and Practice 2012 (2012): 1-6. Web.

     Marfella, R., M. Siniscalchi, K. Esposito, A. Sellitto, U. De Fanis, C. Romano, M. Portoghese, S. Siciliano, F. Nappo, F. C. Sasso, N. Mininni, F. Cacciapuoti, G. Lucivero, R. Giunta, M. Verza, and D. Giugliano. "Effects of Stress Hyperglycemia on Acute Myocardial Infarction: Role of Inflammatory Immune Process in Functional Cardiac Outcome." Diabetes Care 26.11 (2003): 3129-135. Web.

  • Are the claims properly placed in the context of the previous literature?

    The claims are in line with the previous literature. However, the article does not cite any previous studies or results which could help speak to the validity of the article and claims.

  • Do the results support the claims? If not, what other evidence is required?

    The results show that a higher number of adverse cardiovascular events occurred in a group of patients that had glucose levels above 140 mg/dl when compared to a group with glucose levels below 140 mg/dl, upon hospitalization for myocardial infarction. These results support the claim that hyperglycemia may lead to higher instances of adverse cardiovascular events in myocardial infarction patients.

  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    There are no specified deviations reported in the article.

  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    The methodology is explained well and reproducible.

  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Determining whether or not the hyperglycemia occurred due to stress from the myocardial infarction would greatly help support the claim made in the paper. It is mentioned that the hyperglycemia could be brought on by stress or be the result of historically high blood sugar. This distinction is necessary to make in this case due to the specific claim of the paper. In order to test this, patient histories must be obtained and all pertinent information analyzed.


    Additionally, adverse effects were only monitored over a 7 day period. It would be helpful and speak to the validity of the results if the patients were monitored for a longer period of time (i.e. a month) to determine if blood sugar returned to normal after leaving the hospital and if there were anymore cardiovascular events. This would require staying in touch with the patient and return of the patient to the hospital for further testing at least once a week.

  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No, there are many more published articles with similar methods and the same claims that have more evidentiary support. This article does not have enough originality and/or support to be considered an outstanding historical paper.

  • Other Comments:


  • Competing interests:

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  • Have you previously published on this or a similar topic?:
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  • How to cite:  Mulliniks K .Stress Hyperglycemia as a Prognostic Indicator in Non-Diabetic Myocardial Infarction Patients[Review of the article 'Stress Hyperglycemia as a Prognostic Indicator in Non-Diabetic Myocardial Infarction Patients ' by Kumar A].WebmedCentral 2016;7(11):WMCRW003311
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