Role of plasma glucose level on myocardial perfusion in ST-segment elevation myocardial infarction patients

Pepe, Martino; Zanna, Del; Cafaro, Alessandro; Marchese, Alfredo; Addabbo, Francesco; Navarese, Eliano Pio; Napodano, Massimo; Cecere, Annagrazia; Resta, Fabrizio; Paradies, Valeria; Bortone, Alessandro Santo; Favale, Stefano

doi:10.1016/j.jdiacomp.2018.05.015

Cited by 14 publications

(9 citation statements)

References 37 publications

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“…Among acute coronary syndrome patients, patients with stress hyperglycemia had a higher Gensini score, an increased incidence of 6-month major adverse cardiac events and an increased incidence of in-hospital arrhythmia [22]. RBG interferes with blood flow in the culprit vessel and is linearly correlated with the TIMI blood flow index [23]. Some studies have indicated that RBG on admission is closely related to mortality in nondiabetic patients [24].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction

Qin

Yan

et al. 2019

BioMed Research International

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Objective To examine the relationship between admission random blood glucose (RBG), fasting blood glucose (FBG), and Gensini score in patients with acute myocardial infarction (AMI) to clarify the effects of RBG and FBG on the severity of coronary artery disease. Method A total of 958 consecutive AMI patients who underwent emergency coronary angiography at the Cardiology Department of Zhongda Hospital (affiliated with Southeast University) were enrolled in this study from January 1, 2016, to December 31, 2018. The Gensini score of each patient was calculated according to the results of coronary angiography. The RBG, FBG, baseline data, hematological indexes, echocardiography parameters, coronary angiography data, and the use of intra-aortic balloon pump (IABP) were recorded. Patients with an RBG level >11.1 mmol/L were classified into the stress hyperglycemia group, and those with an FBG level >7.0 mmol/L were classified into the elevated FBG group. The Gensini scores in the stress hyperglycemia and elevated FBG groups were compared to those in the control group, and correlations between the RBG and FBG levels and the Gensini scores of AMI patients were evaluated. Independent risk factors for the Gensini score were analyzed by multiple linear and multiple logistic regression analyses. Results The Gensini scores of the stress hyperglycemia group and the elevated FBG group were higher than those of the control group. RBG and FBG were positively correlated with the Gensini score, and there were significant differences between RBG and FBG in different Gensini score groups. After adjusting for confounding factors, multiple linear regression analysis showed that sex, diabetes, estimated glomerular filtration rate (eGFR), and FBG were independent risk factors for the Gensini score. Multiple logistic regression analysis showed that age and FBG were independent risk factors in group 2 compared to group 1, eGFR and FBG were independent risk factors in group 3, and eGFR and FBG were independent risk factors in group 4. Diabetes and RBG were not independent risk factors for the Gensini score. Conclusion The Gensini scores of patients in the stress hyperglycemia group and the elevated FBG group were significantly higher than those in the control group. RBG and FBG were positively correlated with the Gensini score in AMI patients, and FBG was an independent risk factor for the Gensini score in AMI patients.

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Section: Discussionmentioning

confidence: 99%

Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction

Qin

Yan

et al. 2019

BioMed Research International

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“…Growing evidence has illustrated that high glucose was associated with clinical outcomes of STEMI with PCI [ 10 , 11 ]. In addition, increased admission glucose impaired coronary flow in STEMI patients [ 12 , 13 ]. To the best of our knowledge, this was the first study showing that FBG was independently associated with CMR-measured MVO after primary PCI in nondiabetic STEMI patients.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Fasting Blood Glucose for Microvascular Obstruction in Nondiabetic Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention

Wang

et al. 2020

Cardiology Research and Practice

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Background. The relationship between fasting blood glucose (FBG) and microvascular obstruction (MVO) after primary percutaneous coronary intervention (PCI) remains unclear in nondiabetic patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to determine the predictive value of FBG in MVO in nondiabetic STEMI patients. Methods. A total of 108 nondiabetic STEMI patients undergoing primary PCI were enrolled in this study. The patients were classified into either the MVO group or non-MVO group based on cardiac magnetic resonance imaging (CMR). Results. FBG in the MVO group was higher than in the non-MVO group. Univariate analysis showed that FBG, peak high-sensitive troponin T (TnT), pre-PCI thrombolysis in myocardial infarction (pre-PCI TIMI) flow, left ventricular ejection fraction (LVEF), infarction size, left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic volume (LVEDV), and global longitudinal strain (GLS) were likely predictive factors of MVO. After adjustment for other parameters, FBG, peak TnT, LVEF, and LVEDV remained independent predictors for MVO. Conclusion. FBG was independently associated with MVO in nondiabetic STEMI patients.

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“…CS was de ned as systolic blood pressure ≤ 90 mmHg (without inotropic drugs or intra-aortic balloon support) that is unresponsive to intravenous uid administration, secondary to cardiac dysfunction, and associated with signs of hypoperfusion (cold extremities, impaired mental status, or urine output ≤ 30 ml/h). 22 The study population was divided according to the P2Y 12 -I treatment strategy in two groups: patients given an oral P2Y 12 -I and those who received Cangrelor in the CathLab followed by an oral P2Y 12 -I (non-Cangrelor and Cangrelor group respectively).Baseline characteristics, procedural features, and follow-up data of the overall population and per group are presented.…”

Section: Methodsmentioning

confidence: 99%

Comparative effectiveness of Cangrelor in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Insights from the multicenter M.O.Ca. registry

Pepe

Carulli

Larosa

et al. 2023

Preprint

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Background: Cangrelor, the first intravenous P2Y12 inhibitor (P2Y12-I), has been approved on the basis of three large RCTs from the CHAMPION program which nevertheless have been criticized for the low bleeding risk of the enrolled patients, the large quote of chronic coronary syndromes (CCS), and the use of Clopidogrel as control arm even in the setting of acute coronary syndromes (ACS). We sought to investigate, in the setting of ACS, the comparative performance of Cangrelor in terms of in-hospital ischemic and haemorrhagic outcomes compared with the current gold-standard of oral P2Y12-I. Methods: The study retrospectively enrolled 686 consecutive patients admitted to the Divisions of Cardiology of Policlinico of Bari and L. Bonomo Hospital of Andria for ACS and treated with percutaneous coronary intervention (PCI). The study population was divided according to the P2Y12-I treatment strategy in two groups: patients given an oral P2Y12-I and patients receiving Cangrelor in the CathLab followed by an oral P2Y12-I. Clinical endpoints included death, ischemic and bleeding events occurring during hospital stay. Results: Cangrelor treated patients presented higher clinical risk profile at presentation and faced higher death rate. However, after PS matching, in-hospital mortality resulted comparable between the groups and Cangrelor use was associated with reduced in-hospital definite stent thrombosis (p=0.03). Conclusions: Data from our real-world registry highlight that, in the setting of ACS, Cangrelor is prevalently used in patients with very challenging clinical presentations. The adjusted analysis provides for the first time promising data on stent thrombosis reduction associated with Cangrelor use.

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Role of plasma glucose level on myocardial perfusion in ST-segment elevation myocardial infarction patients

Cited by 14 publications

References 37 publications

Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction

Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction

Predictive Value of Fasting Blood Glucose for Microvascular Obstruction in Nondiabetic Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention

Comparative effectiveness of Cangrelor in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Insights from the multicenter M.O.Ca. registry

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