Impact of stress hyperglycemia on in-hospital stent thrombosis and prognosis in nondiabetic patients with ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention

Abstract

In nondiabetic patients with STEMI undergoing p-PCI, the patients with SH experienced a significantly higher incidence of mortality, ST, and composite MACE.

Impact of perioperative hyperglycemia in patients undergoing microvascular reconstruction

“…Although, to the best of our knowledge, no one has previously reported on the impact of perioperative hyperglycemia on microvascular thrombosis in human studies, Colen and colleagues demonstrated that streptozotocin‐induced hyperglycemic rats undergoing anastomosis of the femoral vessels had increased rates of thrombosis. Additionally, multiple studies have demonstrated increased rates of thrombotic complications in patients from other hyperglycemic surgical populations . McGirt et al found increased rates of myocardial infarction, CVA, and transient ischemic attacks in patients with hyperglycemia undergoing carotid endarterectomy that occurred independent of preexisting cardiac disease or a diagnosis of diabetes mellitus.…”

Hyperglycemia in Patients Referred for Cardiac Catheterization Is Associated With Preexisting Diabetes Rather Than a Stress‐Related Phenomenon: A Prospective Cross‐Sectional Study

“…Zhang et al examined the results of 853 patients who were treated by primary PCI for STEMI without DM. Patients with admission serum glucose over 180 mg/dL experienced a significantly higher incidence of mortality, stent thrombosis and composite MACE, and these findings correlate with our results.…”

“…Elevated glucose level during stress is a consequence of sympathetic nervous system activity and overproduction of catecholamines and cortisol, which encourage processes of gluconeogenesis, glycogenolysis, and lipolysis. 21 Zhang et al 22 examined the results of 853 patients who were treated by primary PCI for STEMI without DM. Patients with admission serum glucose over 180 mg/dL experienced a significantly higher incidence of mortality, stent thrombosis and composite MACE, and these findings correlate with our results.…”

Stress hyperglycemia in acute myocardial infarction

“…In PPCI-treated STEMI patients, SH is a marker of both subsequent mortality and more frequent major ad-verse cardiac and cerebrovascular events (MACE) in general [82][83][84] . SH was also associated with increased 30-day rates of reinfarction, acute renal injury, target vessel revascularization (TVR) and major bleeding in 3,405 patients in the HORIZONS-AMI trial 15 .…”

“…Zhang et al 84 studied 853 STEMI patients. Inhospital stent thrombosis was also more commonly seen in patients with SH.…”