Key result
Elevated admission blood glucose and fibrinogen were independent risk factors for slow blood flow during primary PCI in patients with STEMI (P < 0.05).
Why the study?
Whether immediate blood glucose and fibrinogen levels affect coronary blood flow during primary PCI in acute STEMI remained unclear.
Do admission blood glucose and fibrinogen levels predict slow blood flow during primary PCI in patients with STEMI?
Observational (n=497)
No
Do admission blood glucose and fibrinogen levels predict slow blood flow during primary PCI in patients with STEMI?
Elevated admission blood glucose and fibrinogen are independent predictors of coronary slow flow during primary PCI for STEMI, and their combination improves predictive value.
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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Zufei et al. (2024) conducted an observational in Acute ST segment elevation myocardial infarction (STEMI) (n=497). Elevated admission blood glucose (ABG) and fibrinogen (FIB) vs. Normal levels / Control group was evaluated on Slow blood flow during primary PCI (p=<0.05). Elevated admission blood glucose and fibrinogen were independent risk factors for slow blood flow during primary PCI in patients with STEMI (P < 0.05).
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