Hyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
OBJECTIVE
To determine if hyperglycemia on admission correlates to infarct size measured by single-photon emission computed tomography (SPECT) in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).


METHODS
We evaluated 347 STEMI patients who underwent primary PCI. Infarct size was determined by SPECT on Day 5. The population was divided into: hyperglycemia (glycemia on admission >11mmol/L) or non-hyperglycemia (<or=11mmol/L) regardless of diabetic status.


RESULTS
61 (17.6%) patients presented with hyperglycemia on admission. There were no significant differences in baseline characteristics or in PCI characteristics between the two groups. Final TIMI 3 flow was achieved in 81.7% of patients with hyperglycemia vs 85.7% of patients with non-hyperglycemia (p=0.43). The infarct size was larger in the hyperglycemia group (6 [2-14]% vs 8.5 [3-18.25]%; p=0.016). A multivariate linear regression analysis showed that hyperglycemia on admission was an independent predictor of infarct size at Day 5 post-MI (p=0.004).


CONCLUSIONS
In patients with STEMI treated with primary PCI, hyperglycemia on admission is associated with larger infarct size determined by SPECT.
Cruz-Gonzalez
Ignacio
I
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Gray/Bigelow 800, Boston, MA 02114, USA.
Chia
Stanley
S
Raffel
Owen C
OC
Sanchez-Ledesma
Maria
M
Senatore
Fred
F
Wackers
Frans J
FJ
Nathan
David M
DM
Jang
Ik-Kyung
IK
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012044:Regression Analysis; D018570:Risk Assessment; D016896:Treatment Outcome