[Myocardial blush grade, ST-segment elevation resolution and prognosis in acute myocardial infarction patients with or without diabetes mellitus post primary percutaneous coronary intervention].
OBJECTIVE
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).


METHODS
MBG and STR were measured in AMI patients with (n = 95) and without (n = 192) diabetes mellitus after successful primary PCI.


RESULTS
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).


CONCLUSIONS
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.
Zeng
Yong
Y
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academic of Medical Science and Peking Union Medical College, Beijing, China. zengyong1999@medmail.com.cn
Huang
Chao-Lian
CL
Shang
Li-Hua
LH
Zhang
Shu-Yang
SY
Fang
Quan
Q
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D015425:Myocardial Reperfusion; D011379:Prognosis