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Impact of Stress Hyperglycemia on No-Reflow Phenomenon in Patients with ST Elevation Myocardial Infarction Undergoing

Mohamed Khalfallah1, Dina A Maria1, Amany Allaithy1

  • 1Cardiovascular department, Tanta University, EG.

Global Heart
|May 19, 2022
PubMed

Insights

Stress hyperglycemia significantly increases the risk of no-reflow after primary percutaneous coronary intervention (PPCI). This finding is crucial for identifying patients with acute myocardial infarction who may experience poorer outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Interventional Cardiology

Background:

  • Stress hyperglycemia is common in acute myocardial infarction (AMI) and linked to adverse prognosis.
  • Identifying prognostic factors for no-reflow before primary percutaneous coronary intervention (PPCI) is critical.

Purpose of the Study:

  • To investigate the impact of stress hyperglycemia on the no-reflow phenomenon.
  • To compare the incidence of stress hyperglycemia and no-reflow in diabetic versus non-diabetic patients undergoing PPCI for ST-elevation myocardial infarction (STEMI).

Main Methods:

  • A study of 480 patients with STEMI undergoing PPCI.
  • Patients were categorized into normal flow (TIMI 3) and no-reflow (TIMI 0-2) groups.
  • Clinical outcomes, including mortality and major adverse cardiac events, were analyzed.

Main Results:

  • Stress hyperglycemia occurred in 14.8% of non-diabetic and 22.2% of diabetic patients.
  • The incidence of no-reflow was significantly higher in patients with stress hyperglycemia (13.5%).
  • Independent predictors of no-reflow included stress hyperglycemia (OR 3.247), Killip class >1 (OR 1.893), and cardiogenic shock (OR 3.778).

Conclusions:

  • Stress hyperglycemia is associated with an increased incidence of the no-reflow phenomenon post-PPCI.
  • Stress hyperglycemia, elevated Killip class, and cardiogenic shock are independent predictors of no-reflow.
Abstract

Keywords:
ImpactST elevation myocardial infarctionno-reflow phenomenonprimary percutaneous coronary interventionstress hyperglycemia

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