Role of plasma glucose level on myocardial perfusion in ST-segment elevation myocardial infarction patients
Role of plasma glucose level on myocardial perfusion in ST-segment elevation myocardial infarction patients
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DOI：
10.1016/j.jdiacomp.2018.05.015
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发表时间：
2018-08-01
影响因子：
3
通讯作者：
Favale, Stefano
中科院分区：
文献类型：
--
作者：
Pepe, Martino;Zanna, Domenico;Favale, Stefano
目的：高血糖常见于ST段抬高型心肌梗死(STEMI)患者，且与不良预后有关。本研究的目的是评估入院时血糖水平(PGL)与冠状动脉血流速度的相关性。方法：149例STEMI患者接受了直接经皮冠状动脉介入治疗(PPCI)。研究人群根据糖化血红蛋白和糖尿病病史分为两组，并在校正TIMI帧计数(CTFC)方面进行比较。结果：高血糖患者在罪魁祸首(P<；0.0001)和非罪魁祸首血管(P：0.0002)中的CTFC显著升高；糖尿病病史以及罪魁祸首(P<；0.0001)和非罪魁祸首血管(P<；0.0001)的CTFC显著升高(P：0.0001)。在糖尿病患者的亚群中，高血糖患者在罪魁祸首血管(p：0.0013)和非罪魁祸首血管(p：0.0006)中都显示出更高的CTFC。在整个人群中，随着入院PGL的增加，两支血管的CTFC值呈线性增加。结论：入院PGL对罪犯和非罪犯血管的冠脉流量均有影响。已知的糖尿病患者也存在冠脉血流障碍，建议考虑将高血糖作为一个额外的危险因素。我们终于首次证明了PGL和CTFC之间存在着正的线性关系。(C)2018 Elsevier Inc.保留所有权利。
Aims: Hyperglycemia is frequent in patients with ST elevation myocardial infarction (STEMI) and is associated with adverse outcome. Aim of our study was to evaluate the correlation between admission plasma glucose level (PGL) and coronary arteries flow velocity.Methods: We enrolled 149 STEMI patients successfully treated with primary percutaneous coronary intervention (pPCI). The study population was divided into two groups based on PGL (< or >140 mg/dl) and on history of diabetes, and the groups compared in terms of corrected TIMI frame count (cTFC).Results: Hyperglycemic patients had a significantly higher cTFC in both the culprit (p < 0.0001) and non-culprit vessel (p: 0.0002); diabetes history impairs as well cTFC of the culprit (p < 0.0001) and non-culprit vessel (p: 0.0001). Within the subpopulation of diabetic patients hyperglycemic ones showed higher cTFC in both the culprit (p 0.0013) and non-culprit vessel (p: 0.0006). Moreover in the whole population cTFC values of both arteries increase linearly with the increment of admission PGL.Conclusions: Admission PGL affects coronary flow of both culprit and non-culprit vessel. The impairment of coronary flow is also demonstrated in known diabetic patients, suggesting to consider hyperglycemia an additional risk factor. We finally demonstrated for the first time a positive linear relationship between PGL and cTFC. (C) 2018 Elsevier Inc. All rights reserved.