The HbA1c/C-Peptide Ratio is Associated With the No-Reflow Phenomenon in Patients With ST-Elevation Myocardial...

Area of Science:

• Cardiology
• Metabolic Syndrome

Background:

• Primary percutaneous coronary intervention (pPCI) is standard for ST-elevation myocardial infarction (STEMI).
• The no-reflow phenomenon (NR) can occur post-pPCI, leading to adverse outcomes.
• Predictors for NR are crucial for risk stratification and improved patient management.

Purpose of the Study:

• To investigate the association between the HbA1c/C-peptide ratio (HCR) and the incidence of NR in STEMI patients undergoing pPCI.
• To evaluate HCR as an independent predictor of NR, irrespective of diabetic status.

Main Methods:

• A cohort of 1834 STEMI patients undergoing pPCI were analyzed.
• Patients were categorized based on the presence or absence of NR.
• Demographic, clinical, and periprocedural data were compared between groups.
• Multivariable analysis and Receiver Operating Characteristic (ROC) curve analysis were performed.

Main Results:

• No-reflow phenomenon (NR) developed in 19.1% of patients.
• Patients with NR had significantly lower C-peptide levels and higher HbA1c and HCR (P < .001).
• HCR emerged as an independent predictor of NR (P < .05) with 80% specificity and 77% sensitivity in ROC analysis.

Conclusions:

• The HbA1c/C-peptide ratio (HCR) is a significant independent predictor of NR in STEMI patients post-pPCI.
• HCR demonstrates predictive value for NR that is independent of diabetes.
• This ratio may serve as a valuable tool for risk stratification in STEMI patients.