Pakistan Armed Forces Medical Journal (Dec 2023)
Relationship of Admission Glucose level with No-Reflow or Slow Flow in STEMI patients Undergoing Primary Percutaneous Coronary Intervention
Abstract
Objective: To evaluate the association of admission blood glucose levels with no-reflow or slow flow in patients with STElevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI). Study Design: Analytic Cross-sectional study. Place & Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Pakistan, from Jan 2023 till Jun 2023 Methodology: Total 141 STEMI patients (regardless of age and gender) presented in the emergency department with the time duration of 12 hours after onset of chest pain were included in the study by using non-probability Consecutive Sampling technique. Admission glucose levels were measured, and the occurrence of no-reflow or slow flow was assessed using the Thrombolysis in Myocardial Infarction (TIMI) flow score. Statistical analysis, including t-test and Chi-square tests were applied to evaluate the association between glucose levels and no-reflow or slow flow. Level of significance taken was ≤0.05. Results: Out of total 141 patients, mean age of the patients was 61.74+10.87 years and majority were males, 118(83.7%). 101(71.6%) were hypertensive and 69(48.9%) were diabetic. The average admission glucose level was 181.13+112.16mg/dl. Patients with no-reflow or slow flow had significantly higher admission glucose levels compared to those with normal flow (p=0.031). Additionally, a significantly higher number of patients developed no-reflow 4(9.3%) or slow flow 24(55.8%) in the group with admission glucose levels >200 mg/dl (p=0.01). Conclusion: Admission glucose levels may serve as a simple predictor of no-reflow or slow flow in STEMI patients undergoing PPCI, emphasizing the importance of adequate glucose management in these patients.
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