title: Relation of hyperglycemia to ST-segment resolution after reperfusion for acute myocardial infarction (from Observatoire des Infarctus de Côte-d'Or Survey [RICO]).
abstract: Hyperglycemia has been shown to be a powerful predictor of worse outcome after ST-segment-elevation myocardial infarction (STEMI), which could be related to impaired myocardial reperfusion. This study investigated the association between hyperglycemia and ST-segment resolution (STR) after thrombolysis. From the French regional Observatoire des Infarctus de Côte-d'Or survey, admission glucose in 371 patients with STEMIs who were treated by lysis<12 hours was analyzed. The single worst lead electrocardiogram before and 90 minutes after lysis was analyzed, and patients were divided into 3 groups according to the degree of STR: none (<30%), partial (30% to 70%), or complete (>or=70%). Of the 371 patients, 101 (27.2%) had no STR, 124 (33.4%) had partial STR, and 146 (39.4%) had complete STR. STR decreased with increasing glycemia (p=0.029), and patients with hyperglycemia (glycemia>or=11 mmol/L) were more likely to have no STR. Moreover, hyperglycemia was an independent predictor of incomplete STR even after adjustment for potential confounders (odds ratio 2.348, 95% confidence interval 1.212 to 4.547). In conclusion, the present study suggests a strong association between hyperglycemia and electrocardiographic signs of reperfusion in patients with STEMIs after lysis and suggests the usefulness of evaluating early glycemic control in the setting of reperfusion for acute myocardial infarction.
authors.affiliation: Service de Cardiologie, CHU Bocage, and Service de Cardiologie, Centre Hospitalier, Semur en Auxois, Dijon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: L'Huillier
authors.forename: Marianne
authors.initials: M
authors.lastname: Zeller
authors.forename: Laurent
authors.initials: L
authors.lastname: Mock
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Beer
authors.forename: Yves
authors.initials: Y
authors.lastname: Laurent
authors.forename: Pierre
authors.initials: P
authors.lastname: Sicard
authors.forename: Michel
authors.initials: M
authors.lastname: Vincent-Martin
authors.forename: Luc
authors.initials: L
authors.lastname: Lorgis
authors.forename: Hamid
authors.initials: H
authors.lastname: Makki
authors.forename: Jean-Eric
authors.initials: JE
authors.lastname: Wolf
authors.forename: Marc
authors.initials: M
authors.lastname: Freysz
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose