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Association between hyperglycemia at admission and microvascular obstruction in patients with ST-segment elevation

Shingo Ota1, Takashi Tanimoto1, Makoto Orii1

  • 1Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.

Journal of Cardiology
|December 24, 2014
PubMed

Insights

Admission hyperglycemia in ST-segment elevation myocardial infarction (STEMI) patients is linked to microvascular obstruction (MVO). This finding highlights the importance of blood glucose levels in predicting cardiac outcomes after STEMI.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Endocrinology

Background:

  • Admission blood glucose levels in ST-segment elevation myocardial infarction (STEMI) predict heart failure and mortality.
  • Hyperglycemia is associated with microvascular dysfunction.
  • Late gadolinium enhancement cardiovascular magnetic resonance imaging (LGE-CMR) can identify microvascular obstruction (MVO).

Purpose of the Study:

  • To investigate the association between admission hyperglycemia and MVO in STEMI patients using CMR.

Main Methods:

  • Ninety-three STEMI patients treated with percutaneous coronary intervention (PCI) underwent CMR within 7 days.
  • Plasma glucose levels were measured upon admission before medication.
  • LGE-CMR was used to assess the presence of MVO.

Main Results:

  • MVO was present in 37% of patients.
  • Patients with MVO had significantly higher admission glucose levels (204 mg/dl) compared to those without MVO (157 mg/dl).
  • Admission glucose was an independent predictor of MVO, with a threshold of 190 mg/dl effectively identifying MVO presence.

Conclusions:

  • Admission hyperglycemia in STEMI patients treated with PCI is associated with the presence of MVO.
  • This association was assessed using LGE-CMR.
  • Elevated glucose levels at admission may indicate increased risk for MVO in STEMI.
Abstract

Keywords:
Cardiovascular magnetic resonance imagingHyperglycemia at admissionMicrovascular obstruction

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