The effect of admission hyperglycemia on coronary reflow in primary percutaneous coronary intervention / 中华内科杂志

ABSTRACT

Objective To assess the association between admission plasma glucose (APG) and noreflow during primary percutaneous coronary intervention (PCI) in patients with ST-elevation acute myocardial infarction (STEMI). Methods A total of 1413 patients with STEMI successfully treated with PCI were divided into no-reflow group and normal reflow group. Results The no-reflow was found in 297 patients (21.0%) of 1413 patients; their APG level was significantly higher than that of the normal reflow group [( 13.80 ±7.47) vs (9.67 ±5.79) mmol/L, P＜0.0001]. Multivariate logistic regression analysis revealed that current smoking ( OR 1.146, 95% CI 1.026-1. 839,P = 0.031), hyperlipidemia ( OR 1. 082,95% CI 1. 007-1. 162, P = 0. 032), long reperfusion ( ＞ 6 h, OR 1. 271, 95% CI 1. 158-1. 403, P =0. 001 ) , admission creatinine clearance ( ＜ 90 ml/min, OR 1.046, 95% CI 1. 007-1.086, P = 0.020 ) ,IABP use before PCI (OR 9.346, 95%CI 1.314-67. 199, P=0.026), and APG ( ＞ 13.0 mmol/L, OR1.269, 95% CI 1.156-1.402, P = 0.027) were the independent no-reflow predictors. The no-reflow incidence was increased as APG increased ( 14. 6% in patients with APG ＜ 7. 8 mmol/L and 36. 7% in patients with APG ＞ 13.0 mmol/L, P = 0.009 ). Conclusion APG ＞ 13.0 mmol/L is an independent noreflow predictor in patients with STEMI and PPCI.