Key result
Admission hyperglycemia in STEMI linked to lower myocardial salvage and ~8-point larger infarct size.
Why the study?
Cardiovascular complications in STEMI survivors remain substantial despite management advances, prompting investigation into the effect of stress hyperglycemia on myocardial salvage.
Does stress hyperglycemia affect myocardial salvage, infarct size, and area at risk in successfully reperfused STEMI patients?
Observational (n=43)
No
Does stress hyperglycemia affect myocardial salvage, infarct size, and area at risk in successfully reperfused STEMI patients?
Stress hyperglycemia in successfully reperfused STEMI patients is associated with larger infarct size and reduced myocardial salvage as assessed by CMR.
Admission hyperglycemia was associated with reduced salvage in STEMI; leaves open whether glucose control improves outcomes.
Cardiovascular complications in ST-segment-elevation myocardial infarction survivors remain substantial despite advances in the management of STEMI. We aimed to determine effect of AH on the area at risk (AAR), final infarct size (FIS), and salvage index (SI) in STEMI patients using cardiac magnetic resonance (CMR). 43 successfully reperfused STEMI patients were recruited. CMR was utilized to estimate AAR and FIS, SI was calculated: SI = AAR- FIS/AAR. AH showed significant positive correlations to FIS (r-value = 0.538, P = < 0.001), and AAR (r-value = 0.435, P = 0.002), and a negative correlation with SI (r-value = -0.378, P = 0.006).
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Meshref et al. (2020) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=43). Admission hyperglycemia (random plasma glucose >140 mg/dL in non-diabetics or >250 mg/dL in diabetics) vs. Euglycemia at admission was evaluated on Myocardial salvage index (SI) assessed by cardiac magnetic resonance (CMR) (r = -0.378, p=0.031). Admission hyperglycemia in STEMI patients was associated with a smaller myocardial salvage index (0.34 vs 0.38, p=0.031) and larger final infarct size (28.05% vs 19.73%, p=0.022) than euglycemia.
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