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Correlation between admission blood glucose, fibrinogen, and slow blood flow during primary PCI for acute ST segment
Wu Zufei1,2, Su Wentao1,3, Shi Chen4
1Department of Cardiology, The 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, China.
Insights
Elevated blood glucose and fibrinogen levels are linked to coronary slow flow during primary PCI in STEMI patients. Combining these markers improves prediction of slow flow and poor prognosis.
Area of Science:
- Cardiology
- Vascular Biology
- Biochemistry
Background:
- Coronary slow flow (CSF) signifies coronary microcirculation dysfunction.
- CSF is associated with elevated blood glucose and fibrinogen (FIB).
- The immediate impact of blood glucose and FIB on coronary blood flow during primary PCI is not fully understood.
Purpose of the Study:
- To investigate the relationship between admission blood glucose (ABG), FIB, and the occurrence of slow blood flow during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- Retrospective analysis of 497 STEMI patients undergoing primary PCI.
- Patients were categorized into slow blood flow (n=117) and control (n=380) groups.
- Logistic regression and ROC curve analyses were used to identify risk factors and assess predictive values.
Main Results:
- Patients with slow blood flow exhibited significantly higher ABG and FIB levels.
- Multivariate analysis identified FIB and ABG as independent risk factors for slow blood flow (P < 0.05).
- Combined ABG and FIB demonstrated superior predictive value for slow blood flow compared to individual markers (AUC analysis, P < 0.05).
Conclusions:
- Elevated ABG and FIB levels are predictive of slow blood flow during primary PCI in STEMI patients.
- The combined assessment of ABG and FIB offers enhanced diagnostic accuracy for slow blood flow.
- This combined marker aids in evaluating prognosis for STEMI patients undergoing primary PCI.
Backgroud:
Coronary slow flow (CSF) is a common phenomenon of coronary microcirculation dysfunction, and is closely related to elevated blood glucose and fibrinogen (FIB) levels. However, whether immediate blood glucose and FIB levels affect coronary blood flow during primary percutaneous coronary intervention (PCI) remains unclear.
Objective:
To explore the correlation between admission blood glucose (ABG), fibrinogen (FIB) and slow blood flow during primary PCI for acute ST segment elevation myocardial infarction (STEMI).
Methods:
A total of 497 patients who underwent coronary angiography in the cardiology department of the 904th Hospital of the Joint Logistics Support Force from December 2018 to December 2022 due to STEMI were selected consecutively, and then were divided into two groups based on whether slow blood flow occurred during primary PCI: slow blood flow group (n = 117) and control group (n = 380). Detecting the ABG, FIB and other indicators of patients in each group, and using logistic regression analysis and receiver operating characteristic (ROC) curve to analyze independent risk factors for slow blood flow during primary PCI, and further evaluating the prognosis of patients.
Results:
The levels of ABG and FIB in patients with slow blood flow were significantly higher than those in the control group (P < 0.05). The results of multivariate logistic regression analysis suggested that FIB and ABG were independent risk factors for slow blood flow during primary PCI (both P < 0.05). ROC curve analysis showed that ABG, FIB, and their combination all had predictive value for slow blood flow during primary PCI (all P < 0.05), and the area under the curve (AUC) of the combined indicator was higher than that of any single indicator, with statistical significance (P < 0.05). KM curve analysis suggested that the prognosis of patients in slow blood flow group were poor.
Conclusion:
Both elevated ABG and FIB could predict slow blood flow during primary PCI, and the diagnostic value of the combined indicator was superior to that of any single indicator, which could be used for the evaluation of slow blood flow during primary PCI, so as to evaluate the prognosis of patients with STEMI.
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