Impact of stress-induced hyperglycemia on angiographic findings in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background and aim Acute coronary syndrome represents one of the most relevant cardiovascular disorders worldwide. We aimed to assess the impact of stress-induced hyperglycemia (SIH) on angiographic findings in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Patients and methods This prospective study was carried out on 200 patients recruited to the study at initial presentation with STEMI who were managed by PPCI and received the standard of care in Al-Azhar University Assiut Cath laboratory. All patients were divided into two equal groups: group 1 ( n =100): patients who developed SIH. Group 2 ( n =100): patients without SIH. Results Poor postprocedural thrombolysis in myocardial infarction flow was significantly higher in SIH patients (40 vs. 15%; P <0.001, odds ratio=3.8, 95% confidence interval: 1.9–7.6). Preprocedural thrombolysis in myocardial infarction flow grade 0 predominated in SIH (95 vs. 60%; P <0.001). SIH correlated with larger thrombus burden (65 vs. 40%; P =0.00068), no-reflow (45 vs. 20%; P =0.00029), and lower left ventricle ejection fraction (43 vs. 45.8%; P <0.001). Conclusions SIH is associated with more severe coronary artery disease, poorer angiographic outcomes, and reduced cardiac function in STEMI patients undergoing PPCI. These findings emphasize the importance of recognizing and addressing SIH in the management of acute coronary syndromes to improve outcomes in this high-risk patient population potentially.