Impact of hyperglycemia on the results of percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction

Abstract

Aim. To investigate the impact of hyperglycemia on the results of percutaneous coronary interventions (PCIs) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Subjects and methods. A study group consisted of 511 patients with hyperglycemia (blood glucose level (BGL) ≥7.77 mmol/L) who underwent primary PCIs in the period from 2005 to 2015. A comparison group included 579 patients (BGL ≥7.77 mmol/L). Results. Assessment of the results of hospital interventions revealed that the mortality rates in patients with hyperglycemia proved to be higher than in those with normal BGL (6.5 and 2.6%, respectively; p=0.002). No differences were found in the rates of stent thrombosis (1 and 1.4%; p=0.541) and recurrent myocardial infarction (1.2 and 1.6%; p=0.591). Major adverse cardiac events, including death, recurrent infarction, and stent thrombosis, were more frequently determined in the hyperglycemic patients (7.6 and 4.3%; p=0.020). No-reflow phenomenon statistically significantly more frequently developed in the patients with hyperglycemia (6.8 and 3.3%; p=0.007). Binary logistic regression analysis showed that the presence of hyperglycemia served as an independent predictor of hospital mortality (odds ratio (OR) 2.6; 95% confidence interval (CI), 1.4 to 4.8; p=0.002). The application of a random probability sampling technique revealed that mortality remained statistically significantly higher in the hyperglycemic patients than in the normoglycemic individuals at admission (6.7 and 2.6%; р=0.011). Conclusion. PCIs in patients with ASTEMI and hyperglycemia are characterized by higher mortality rates and the risk of major adverse cardiac events. Admission hyperglycemia is an independent predictor of hospital mortality.

Keywords

• st-segment elevation myocardial infarction
• primary percutaneous coronary interventions
• hyperglycemia