Myocardial blush grade, ST-segment elevation resolution and prognosis in acute myocardial infarction patients with or without diabetes mellitus post primary percutaneous coronary intervention / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVES</b>To investigated the prognosis of primary percutaneous coronary intervention (PCI) in acute myocardial infarction patients with or without diabetes mellitus (DM) in terms of myocardial blush grade (MBG) and ST-segment elevation resolution (STR).</p><p><b>METHODS</b>MBG and STR were measured in AMI patients with (n = 95) and without (n = 192) diabetes mellitus after successful primary PCI.</p><p><b>RESULTS</b>Post-procedural TIMI grade 3 flow (>95%) were similar between two groups. Compared to non-DM patients, DM patients were more likely to have absent myocardial perfusion (MBG 0/1, 56.0% vs. 41.1%, P = 0.019) and absent STR (43.2% vs. 30.7%, P = 0.038). MACE rate was also higher in DM patients than that in non-DM patients during follow-up (27.4% vs. 16.1%, P = 0.025). Multivariate analysis showed DM was an independently factor related to the risk of poor prognosis (RR 1.83, 95% CI 1.04 - 3.36], P = 0.01).</p><p><b>CONCLUSION</b>Despite similar TIMI-3 flow after primary PCI, DM patients are more likely to have abnormal myocardial perfusion as assessed by both incomplete STR and reduced MBG and poor prognosis compared to non-DM patients. Poor prognosis in DM patients with AMI post PCI might be related to more disturbed micro-vascular perfusion.</p>