Correlation analysis of Gensini score in T2DM patients with STEMI

Background The high value of Gensini score may be correlated with the high level of glycated hemoglobin (HbA1C) identifying STEMI patients at risk for complications during percutaneous coronary intervention (PCI), either insulin-dependent or non-insulin-dependent type 2 diabetes mellitus (T2DM). Purpose We evaluated Gensini score after PCI in STEMI patients with T2DM correlating to the level of HbA1C. Methods In this study we included one hundred and thirty-one consecutive T2DM patients with STEMI of onset < 12h who underwent primary percutaneous coronary intervention (pPCI). The levels of creatine kinase (CK), the MB fraction of creatine kinase (CK-MB), troponin T, HbA1C, CRP, and other routine laboratory parameters were measured. Measurement of HbA1C was done on the day of admission before PCI with ion-exchange high performance liquid chromatography (HPLC) (HbA1C kit, Roche Diagnostics, Mannheim, Germany). Post PCI procedures patients were divided in two groups according to the value of Gensini score. Results After the receiver operating characteristic (ROC) curve analysis, patients were classified into two groups according to the cut-off value: 74 patients were with low Gensini score (≤ 73) and 57 patients were with high Gensini score (>73). As shown in Fig.1, the AUC=0.82 (95% CI, 0.75-0.89; p<0.0001; cut-off value of 73). In total 52 (39.69%) patients suffered from triple vessel coronary artery disease, 18 (13.74.5%) of whom with Gensini score ≤ 73 and 34 (25.95%) with value > 73 (p < 0.0001). As for the patients with T2DM, the patients with Gensini score ≤ 73 had a value of HbA1C of 7.89 (±2.28) as well as 9.94 (±1.87) to those with value > 73 (p < 0.0001) (Table 1). Conclusions Predicting of Gensini score based on the level of HbA1C in STEMI patients with T2DM may be identify the risk for complications during PCI, therefore warranting a more rigorous glycemic control.