Effect of diabetes on scintigraphic infarct size in STEMI patients undergoing primary angioplasty.
BACKGROUND
It has been shown that among patients with ST-segment elevation myocardial infarction (STEMI), diabetes is associated with a significantly higher mortality, mainly because of impaired reperfusion. However, few data have been reported so far on infarct size as evaluated by well-refined techniques, such as nuclear imaging techniques. Therefore, the aim of the current study was to investigate the effect of diabetes in infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI.


METHODS
We included 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99 m-sestamibi. A logistic regression analysis was performed to determine the relation between diabetes and infarct size (as above the median) after correction for baseline confounding factors.


RESULTS
A total of 115 (13.8%) out of 830 patients suffered from diabetes. Diabetic patients were older (p < 0.001), with larger prevalence of female gender (p = 0.006) and hypertension (p = 0.001) but were less often smokers (p = 0.003). Diabetic patients had more often preprocedural thrombolysis in myocardial infarction grade 3 flow (p = 0.034) and less complete ST-segment resolution (p = 0.009). No difference was observed in scintigraphic infarct size between diabetes and control patients (p = 0.6)), which was confirmed at multivariate analysis after correction for baseline confounding factors (Adjusted OR [95% CI] = 0.87 [0.57-1.31, p = 0.51).


CONCLUSIONS
Our study showed that among STEMI patients undergoing primary angioplasty, diabetes did not affect infarct size as compared with non-diabetic patients.
Division of Cardiology, "Maggiore della Carità" Hospital, Eastern Piedmont University, Novara, Italy.
Giuseppe
G
De Luca
Guido
G
Parodi
Roberto
R
Sciagrà
Benedetta
B
Bellandi
Ruben
R
Vergara
Angela
A
Migliorini
Renato
R
Valenti
David
D
Antoniucci
D000368:Aged; D017130:Angioplasty; D016022:Case-Control Studies; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011379:Prognosis
STEMI; diabetes; infarct size; myocardial scintigraphy