title: Prognostic Impact of Combined Dysglycemia and Hypoxic Liver Injury on Admission in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (from the INTERSTELLAR Cohort).
abstract: Dysglycemia on admission is known to predict the prognosis of ST-segment elevation myocardial infarction (STEMI). Recently, hypoxic liver injury (HLI) has been proposed as a novel prognosticator for STEMI. We evaluated the prognostic impact of combined dysglycemia and HLI at the time of presentation in patients with STEMI who underwent primary percutaneous coronary intervention. From 2007 to 2014, 1,525 consecutive patients (79% men, mean age 61 years) who underwent primary percutaneous coronary intervention for STEMI in the INTERSTELLAR (Incheon-Bucheon Cohort of Patients Undergoing Primary PCI for Acute ST-Elevation Myocardial Infarction) cohort were analyzed retrospectively. Dysglycemia was defined as either hypoglycemia (serum glucose <90 mg/dl) or hyperglycemia (serum glucose >250 mg/dl). HLI was defined as more than twofold increase of any serum aminotransferases above the upper normal limit. Patients were divided into 4 groups according to their dysglycemia and HLI status on admission: group 1, normoglycemia without HLI; group 2, dysglycemia without HLI; group 3, normoglycemia with HLI; and group 4, dysglycemia with HLI. Primary end point was inhospital death and secondary end point was all-cause mortality at 12 months after the index procedure. Of the 1,525 patients, there were 87 inhospital deaths (5.7%) and 113 all-cause deaths (7.4%) at 12 months after the index procedure. Both dysglycemia and HLI on admission were independent predictors of inhospital death. Inhospital mortality rate was the highest in group 4 (32.1%), followed by groups 2 and 3. Kaplan-Meier survival analysis at 12 months showed similar trends among the 4 groups. In conclusion, combined dysglycemia and HLI on admission predicts early prognosis for STEMI.
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Ho-Jun
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Pyung Chun
authors.initials: PC
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Jeonggeun
authors.initials: J
authors.lastname: Moon
authors.affiliation: Division of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Jon
authors.initials: J
authors.lastname: Suh
authors.affiliation: Division of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Park
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Park
authors.affiliation: Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Kyounghoon
authors.initials: K
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Je Sang
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Rak Kyeong
authors.initials: RK
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Kwon
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea. Electronic address: sch.kimtaehoon@gmail.com.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000401:mortality*; D007003:Hypoglycemia / Q000401:mortality*; D000860:Hypoxia / Q000401:mortality*; D008099:Liver / Q000098:blood supply / Q000293:injuries; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D000637:Transaminases / Q000097:blood
chemical_list: D000637:Transaminases