Key result
High blood glycemia was an independent predictor of death and major cardiovascular events in patients with STEMI undergoing PCI, whereas diabetes mellitus was not.
Why the study?
The study was conducted to evaluate the impact of diabetes mellitus and blood glucose levels on treatment outcomes in patients with STEMI undergoing PCI.
Does high blood glucose or diabetes mellitus impact in-hospital outcomes in patients with STEMI undergoing PCI?
Cohort (n=1,280)
Does high blood glucose or diabetes mellitus impact in-hospital outcomes in patients with STEMI undergoing PCI?
Admission hyperglycemia, rather than a history of diabetes mellitus, is a strong independent predictor of adverse in-hospital outcomes including death and MACE in STEMI patients undergoing PCI.
Answers are grounded in this paper and cite their sources.
Hyperglycemia may flag higher in-hospital risk in STEMI PCI patients; hypothesis-generating for glucose-targeted trials independent of DM.
The aim of this study was to evaluate the impact of diabetes mellitus (DM) and glucose levels on the results of treatment of patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary interventions (PCIs). MATERIALS AND METHODS: Data were collected from all patients (n=1280) with STEMI who were admitted to the coronary care unit and underwent PCIs from 2006 to 2015. 212 (16.6%) patients with DM were compared with 1068 (83.4%) patients without DM (non-DM group). To investigate the influence of the blood glucose levels, all patients were divided into two groups above and below the median of blood glycemia (7.52 mmol/l). RESULTS: Thus, 634 patients with high level of blood glycemia (>7.52 mmol/l) were compared with 635 patients with low level of blood glycemia (≤7.52 mmol/l). In comparing of DM and non-DM groups there were no differences in the rate of death (5.2% vs 4.2%, р=0.526), stent thrombosis (1.4% vs 1.0%, р=0.622), recurrent myocardial infarction (MI) (1.4% vs 1.2%, р=0.813) and major adverse cardiac events (MACE) (7.5% vs 5.4%, р=0.228), which included in-hospital death, recurrent MI and stent thrombosis. The rates of angiographic success (92.9% vs 93.8%, р=0.625) and no-reflow (6.6% vs 5%, р=0.327) also were comparable between groups. The rates of death (6.3% vs 2.5%, р=0.001), MACEs (7.6% vs 4.1%, р=0.008), and no-reflow (6.9% vs 3.6%, р=0,009) were significantly higher in patients with high level of blood glycemia (>7.52 mmol/l). Angiographic success rate (95.1% vs 92.1%, р=0.029) was higher in patients with low level of glycemia (≤7.52 mmol/l). After multivariate adjustment, high level of blood glycemia (>7.52 mmol/l) remained an independent predictor of death (OR=2.28; 95% CI 1.18-4.40, р=0.014), MACE (OR=2.08; 95% CI 1.16-3.75, р=0.014) and no-reflow (OR=2.07; 95% CI 1.15-3.74, р=0.015). At the same time DM wasn't associated with death, MACE or no-reflow. CONCLUSION: High level of blood glycemia was an independent predictor of death, MACE and no-reflow in patients with STEMI, undergoing PCI. The presence of DM was not associated with worse in-hospital outcomes.
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Бессонов et al. (2019) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=1,280). High blood glycemia (>7.52 mmol/l) vs. Low blood glycemia (≤7.52 mmol/l) was evaluated on Death (OR 2.28, 95% CI 1.18-4.40, p=0.014). High blood glycemia was an independent predictor of death and major cardiovascular events in patients with STEMI undergoing PCI, whereas diabetes mellitus was not.
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