Impact of acute hyperglycemia during primary stent implantation in patients with ST-elevation myocardial infarction.
BACKGROUND
Acute hyperglycemia is associated with increased mortality rates in patients with acute coronary syndrome.


OBJECTIVE
This study aimed to evaluate the relationship between the glucose level and clinical variables during primary intervention in patients with ST-elevation acute myocardial infarction (STEMI).


RESULTS
Of consecutive 94 patients with STEMI treated by primary stent implantation, acute hyperglycemia (plasma glucose level on admission>198 mg/dl) was recognized in 29 patients. There were no significant differences in baseline characteristics, except for the presence of diabetes and HbA(1c) level, between patients with and without acute hyperglycemia. In patients with acute hyperglycemia, corrected TIMI frame counts were significantly higher compared with those in patients without acute hyperglycemia (46.3+/-30.3 vs. 34.0+/-17.9, p=0.02). And corrected TIMI frame count was independently associated with plasma glucose level (p=0.006). Maximum level of creatine kinase (CK) and CK-MB were significantly higher in patients with acute hyperglycemia (CK, 4840.0+/-4690.3 vs. 2410.7+/-2302.9 IU, p=0.001; CK-MB, 315.3+/-257.7 vs. 195.9+/-191.1, p=0.01).


CONCLUSIONS
The presence of acute hyperglycemia was associated with the impairment of epicardial coronary flow after primary stent implantation. This mechanism might be responsible for the increased infarct size.
Nakamura
Tomohiro
T
Cardiovascular Division, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma, Omiya, Saitama 330-8503, Japan. v
Ako
Junya
J
Kadowaki
Tomoko
T
Funayama
Hiroshi
H
Sugawara
Yoshitaka
Y
Kubo
Norifumi
N
Momomura
Shinichi
S
D000208:Acute Disease; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D015607:Stents
D001786:Blood Glucose; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form