Effect of diabetes on scintigraphic infarct size in STEMI patients undergoing primary angioplasty
Related Experiment Video
Updated: Apr 21, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Giuseppe De Luca1, Guido Parodi, Roberto Sciagrà
1Division of Cardiology, "Maggiore della Carità" Hospital, Eastern Piedmont University, Novara, Italy.
Insights
Diabetes does not impact infarct size in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI. This finding contrasts with higher mortality observed in diabetic STEMI patients, highlighting the need for further research into reperfusion mechanisms.
Area of Science:
- Cardiology
- Diabetology
- Nuclear Imaging
Background:
- Diabetes is linked to higher mortality in ST-segment elevation myocardial infarction (STEMI) patients, potentially due to impaired reperfusion.
- Limited data exist on diabetes' effect on infarct size using advanced imaging techniques.
- This study aimed to assess diabetes' impact on infarct size in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
Purpose of the Study:
- To investigate the relationship between diabetes and myocardial infarct size.
- To evaluate infarct size using myocardial scintigraphy in STEMI patients.
- To analyze the effect of diabetes on infarct size after primary PCI.
Main Methods:
- A cohort of 830 STEMI patients undergoing primary PCI was analyzed.
- Infarct size was quantified using technetium-99m-sestamibi myocardial scintigraphy at 30 days post-event.
- Logistic regression was employed to determine the association between diabetes and infarct size, adjusting for confounding factors.
Main Results:
- Diabetic patients (13.8%) were older, more frequently female, and had hypertension, but were less likely to smoke.
- Diabetic patients showed more favorable preprocedural flow and less complete ST-segment resolution.
- No significant difference in scintigraphic infarct size was observed between diabetic and non-diabetic patients (p=0.6), even after multivariate adjustment.
Conclusions:
- Diabetes does not significantly influence infarct size in STEMI patients treated with primary angioplasty.
- These findings suggest that other factors beyond infarct size may contribute to the increased mortality observed in diabetic STEMI patients.
Background:
It has been shown that among patients with ST-segment elevation myocardial infarction (STEMI), diabetes is associated with a significantly higher mortality, mainly because of impaired reperfusion. However, few data have been reported so far on infarct size as evaluated by well-refined techniques, such as nuclear imaging techniques. Therefore, the aim of the current study was to investigate the effect of diabetes in infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI.
Methods:
We included 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99 m-sestamibi. A logistic regression analysis was performed to determine the relation between diabetes and infarct size (as above the median) after correction for baseline confounding factors.
Results:
A total of 115 (13.8%) out of 830 patients suffered from diabetes. Diabetic patients were older (p < 0.001), with larger prevalence of female gender (p = 0.006) and hypertension (p = 0.001) but were less often smokers (p = 0.003). Diabetic patients had more often preprocedural thrombolysis in myocardial infarction grade 3 flow (p = 0.034) and less complete ST-segment resolution (p = 0.009). No difference was observed in scintigraphic infarct size between diabetes and control patients (p = 0.6)), which was confirmed at multivariate analysis after correction for baseline confounding factors (Adjusted OR [95% CI] = 0.87 [0.57-1.31, p = 0.51).
Conclusion:
Our study showed that among STEMI patients undergoing primary angioplasty, diabetes did not affect infarct size as compared with non-diabetic patients.
