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Hyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for

Ignacio Cruz-Gonzalez1, Stanley Chia, Owen C Raffel

  • 1Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Gray/Bigelow 800, Boston, MA 02114, USA.

Diabetes Research and Clinical Practice
|January 20, 2010
PubMed

Insights

Hyperglycemia on admission is linked to larger infarct sizes in ST-segment elevation myocardial infarction (STEMI) patients treated with percutaneous coronary intervention (PCI). This finding highlights the impact of blood glucose levels on heart attack outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Imaging

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) requires timely reperfusion therapy.
  • Hyperglycemia is a common finding in acute myocardial infarction.
  • The prognostic significance of admission hyperglycemia in STEMI patients undergoing primary percutaneous coronary intervention (PCI) requires further clarification.

Purpose of the Study:

  • To investigate the association between admission hyperglycemia and infarct size in STEMI patients treated with primary PCI.
  • To determine if hyperglycemia predicts larger myocardial infarct size.

Main Methods:

  • A cohort of 347 STEMI patients undergoing primary PCI was analyzed.
  • Infarct size was quantified using single-photon emission computed tomography (SPECT) on Day 5 post-intervention.
  • Patients were categorized into hyperglycemia (>11 mmol/L) and non-hyperglycemia (≤11 mmol/L) groups based on admission glucose levels.

Main Results:

  • 17.6% of patients presented with hyperglycemia on admission.
  • No significant differences in baseline or PCI characteristics were observed between groups.
  • The hyperglycemia group exhibited a significantly larger infarct size (8.5% vs 6%; p=0.016).
  • Multivariate analysis identified admission hyperglycemia as an independent predictor of Day 5 infarct size (p=0.004).

Conclusions:

  • Admission hyperglycemia is independently associated with larger infarct size in STEMI patients treated with primary PCI.
  • These findings suggest that glycemic control on admission may be crucial for limiting infarct size and improving outcomes in STEMI.
Abstract

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