Effect of intracoronary thrombectomy on 30-day mortality in non-diabetic patients with acute hyperglycemia after acute myocardial infarction.
BACKGROUND
There is limited evidence about useful therapeutic interventions for patients with acute hyperglycemia (AH) after acute myocardial infarction (AMI).


METHODS
We studied 2433 consecutive non-diabetic AMI patients who underwent percutaneous coronary intervention (PCI) within 24h after the onset. Patients were divided into two groups according to the presence or absence of AH (admission serum glucose level ≥ 11.1 mmol/l). We assessed the association between intracoronary thrombectomy and the clinical outcome in AMI patients with AH.


RESULTS
Patients with AH had more risk factors than those without AH. The 30-day mortality rate of patients with AH was significantly higher than that of those without (11.7% vs 1.7%, p<0.001). Among patients with AH, the 30-day mortality rate was significantly lower for those with intracoronary thrombectomy than those without it (4.9% vs 17.2%, p=0.004). Among patients without AH, however, the 30-day mortality rate was similar between those with and without intracoronary thrombectomy (1.5% vs 1.9%, p=NS). Multivariate analysis showed that intracoronary thrombectomy was associated with an improved 30-day mortality rate for patients with AH (hazard ratio: HR 0.184, 95% CI 0.057-0.598, p=0.005).


CONCLUSIONS
In AMI patients with AH, intracoronary thrombectomy prior to PCI might improve the 30-day mortality rate.
Usami
Masaya
M
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Sakata
Yasuhiko
Y
Nakatani
Daisaku
D
Shimizu
Masahiko
M
Suna
Shinichiro
S
Matsumoto
Sen
S
Hori
Masatsugu
M
Sato
Hiroshi
H
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate; D017131:Thrombectomy; D013997:Time Factors; D016896:Treatment Outcome