Related Experiment Video

Updated: Sep 27, 2026

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
09:35

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia

Published on: November 15, 2024

Association between hyperglycemia and the no-reflow phenomenon in patients with acute myocardial infarction

Katsuomi Iwakura1, Hiroshi Ito, Masashi Ikushima

  • 1Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka University, Osaka, Japan.

Journal of the American College of Cardiology
|February 7, 2003
PubMed

Insights

Hyperglycemia in acute myocardial infarction (AMI) patients is linked to the no-reflow phenomenon, indicating impaired microvascular function. This suggests higher blood glucose levels may worsen infarct size and recovery after AMI.

Area of Science:

  • Cardiology
  • Metabolic Disorders

Background:

  • Hyperglycemia is a known risk factor for adverse outcomes post-acute myocardial infarction (AMI).
  • The specific mechanisms linking hyperglycemia to poor outcomes in AMI patients, such as the no-reflow phenomenon, remain unclear.

Purpose of the Study:

  • To investigate the association between hyperglycemia and the occurrence of the no-reflow phenomenon in patients experiencing their first AMI.
  • To explore the potential impact of hyperglycemia on microvascular function and infarct size following AMI.

Main Methods:

  • 146 patients with a first AMI underwent intracoronary myocardial contrast echocardiography (MCE) post-reperfusion.
  • Echocardiography was used to assess wall motion score changes (DeltaWMS) at day 1 and 3 months post-infarction.
  • Blood glucose levels on admission were analyzed in relation to the presence of the no-reflow phenomenon.

Main Results:

  • The no-reflow phenomenon was observed in 33.6% of patients.
  • Patients with hyperglycemia (blood glucose ≥160 mg/dl) exhibited a significantly higher incidence of no-reflow (52.0% vs. 14.1%).
  • Hyperglycemic patients had higher peak creatine kinase levels and a lower DeltaWMS, suggesting larger infarct size and poorer functional recovery.

Conclusions:

  • Hyperglycemia is significantly associated with the no-reflow phenomenon in AMI patients.
  • Impaired microvascular function may be a key mechanism linking hyperglycemia to worse outcomes after AMI.
  • Blood glucose level is an independent prognostic factor for no-reflow post-AMI.
Abstract

More Related Videos

Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography09:23

Confirmation of Myocardial Ischemia and Reperfusion Injury in Mice Using Surface Pad Electrocardiography

Published on: November 24, 2016

Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...