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Hyperglycemia and intramyocardial hemorrhage in patients with ST-segment elevation myocardial infarction

Shingo Ota1, Tsuyoshi Nishiguchi2, Akira Taruya1

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

Journal of Cardiology
|June 24, 2022
PubMed

Insights

Hyperglycemia (high blood sugar) upon admission is linked to intramyocardial hemorrhage (IMH) in ST-segment elevation myocardial infarction (STEMI) patients. Elevated glucose levels also correlate with matrix metalloproteinase-9 (MMP-9), a factor in IMH development.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Hyperglycemia and intramyocardial hemorrhage (IMH) are linked to poor outcomes in ST-segment elevation myocardial infarction (STEMI).
  • The relationship between admission glucose levels and IMH, and the role of matrix metalloproteinase-9 (MMP-9) in hyperglycemia-associated IMH, remain unclear.

Purpose of the Study:

  • To investigate the association between hyperglycemia at admission and the presence of IMH in STEMI patients.
  • To explore the relationship between admission glucose levels, IMH, and MMP-9 levels.

Main Methods:

  • 174 STEMI patients undergoing primary percutaneous coronary intervention (PCI) were assessed using cardiovascular magnetic resonance (CMR) imaging.
  • T2-weighted and late gadolinium enhancement (LGE)-CMR were used to detect IMH and microvascular obstruction (MVO).
  • MMP-9 levels were measured in the culprit coronary arteries of a subset of patients.

Main Results:

  • Patients with IMH had significantly higher admission glucose levels (208.5 vs. 157.0 mg/dL) and HbA1c (6.2% vs. 5.8%) compared to those without IMH.
  • Admission glucose level was an independent predictor of IMH (OR: 1.012; 95% CI: 1.005-1.020).
  • MMP-9 levels were higher in patients with IMH (256.0 vs. 73.5 ng/mL) and positively correlated with admission glucose levels (r=0.600).

Conclusions:

  • Hyperglycemia at admission is significantly associated with the occurrence of IMH in STEMI patients.
  • Elevated MMP-9 levels in STEMI patients with IMH may be linked to hyperglycemia.
Abstract

Keywords:
HyperglycemiaIntramyocardial hemorrhageMatrix metalloproteinase-9ST-segment elevation myocardial infarction

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