Postprocedural hyperglycemia in ST elevation myocardial infarction submitted to percutaneous coronary intervention: a prognostic indicator and a marker of metabolic derangement

Autor: Andrea Sori, Gian Franco Gensini, Serafina Valente, Marco Chiostri, Chiara Lazzeri
Rok vydání: 2010
Předmět:
Blood Glucose
Male
Time Factors
medicine.medical_treatment
Myocardial Infarction
Risk Factors
Natriuretic Peptide
Brain
Troponin I
Odds Ratio
Creatine Kinase
MB Form
Hospital Mortality
Prospective Studies
Myocardial infarction
Angioplasty
Balloon
Coronary
Aged
80 and over
Ejection fraction
biology
General Medicine
Middle Aged
C-Reactive Protein
Treatment Outcome
Cardiology
Female
Inflammation Mediators
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Acute coronary syndrome
Blood Sedimentation
Risk Assessment
Predictive Value of Tests
Internal medicine
Diabetes mellitus
medicine
Humans
Lactic Acid
Aged
Proportional Hazards Models
Killip class
business.industry
Myocardium
C-reactive protein
Percutaneous coronary intervention
Stroke Volume
medicine.disease
Peptide Fragments
Logistic Models
Hyperglycemia
biology.protein
business
Biomarkers
Zdroj: Journal of Cardiovascular Medicine. 11:7-13
ISSN: 1558-2027
DOI: 10.2459/jcm.0b013e32832d83b3
Popis: BACKGROUND: Hyperglycemia in acute coronary syndrome is associated with an increased risk of death in patients without previously known diabetes but the prognostic role of postrevascularization hyperglycemia in these patients is so far incompletely elucidated. MATERIALS AND METHODS: In 175 consecutive patients without previously known diabetes and with ST elevation myocardial infarction treated with primary angioplasty, we evaluated the relation between acute and chronic glucose dysmetabolism and early and late mortality and the relation between hyperglycemia and extension of myocardial damage [creatine phosphokinase-MB (CPK-MB), troponin I levels, ejection fraction], inflammation (leukocyte count, erythrocyte sedimentation rate, C-reactive protein) and prognostic biohumoral markers [N-terminal brain natriuretic peptide (NT-proBNP) and lactic acid]. RESULTS: Highest glucose levels were associated with higher Killip class, lower ejection fraction and increased values of CPK, CPK-MB, troponin I, proBNP, lactic acid, leukocytes and insulin. At multivariate logistic regression analysis, the following variables were independent predictors of intraintensive cardiac care unit mortality: postprocedural glycemia [odds ratio (OR) 8.79; 95% confidence interval (CI) 1.41-54.94; P = 0.020] and troponin I (OR 1.003; 95% CI 1.0004-1.006; P = 0.023) when adjusted for insulinemia [OR 0.98; 95% CI 0.92-1.06; P = not significant (NS)], HbA1c (OR 0.51; 95% CI 0.11-2.37; P = NS), ST elevation myocardial infarction location (OR 1.27; 95% CI 0.44-3.66; P = NS) and creatininemia (OR 1.48; 95% CI 0.90-2.45; P = NS). CONCLUSION: In ST elevation myocardial infarction patients without previously known diabetes submitted to percutaneous coronary intervention, glucose serum levels measured after mechanical revascularization were independent predictors of in-hospital mortality.
Databáze: OpenAIRE
Externí odkaz: