Relationship between TIMI frame count and admission glucose values in acute ST elevation myocardial infarction patients who underwent successful primary percutaneous intervention
Relationship between TIMI frame count and admission glucose values in acute ST elevation myocardial infarction patients who underwent successful primary percutaneous intervention
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DOI：
10.5152/akd.2011.055
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发表时间：
2011-05-01
影响因子：
--
通讯作者：
Korkmaz, Sule
中科院分区：
文献类型：
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作者：
Ege, Meltem;Guray, Umit;Korkmaz, Sule
目的：急性心肌梗死患者入院时高血糖与预后不良相关。尽管直接经皮冠状动脉介入治疗（PCI）后冠状动脉再灌注成功，但罪犯冠状动脉的最终心肌梗死溶栓（TIMI）帧数可能显示出显著的变异性。在这项前瞻性观察性研究中，研究了因急性ST段抬高型心肌梗死（STEMI）而成功接受直接PCI的患者的罪犯冠状动脉的最终TIMI帧计数与入院血糖值之间的关系。在六个月的时间里，本研究连续纳入了73例接受直接PCI且最终TIMI血流3级的急性STEMI非糖尿病患者。根据最终TIMI帧数将患者分为两组。第1组（n=53）包括罪犯冠状动脉的最终TIMI帧计数在预定值的两个标准差内的患者，第2组（n=20）包括TIMI帧计数较高的患者。结果：尽管空腹血糖值相似，但第2组入院时血糖水平显著高于第1组（138 [114-165] vs. 123 [97-143] mg/dl，p=0.03）。在整个组中，入院血糖值与罪犯冠状动脉的校正TIMI帧数显著相关（r=0.30，p=0.01）。此外，入院血糖值与肌酸激酶MB峰值（r=0.36，p=0.007）以及左心室射血分数（r=-0.43，p=0.009）之间存在显著相关性。在多元线性回归分析中，只有入院时血糖值被发现与罪犯动脉的最终TIMI帧数显著相关（β =0.04，95%CI：0.02-0.085，p=0.04）。结论：即使在非糖尿病STEMI患者成功进行直接PCI后，高入院时血糖值也与冠状动脉血流受损显著相关。（Anadolu Kardiyol Derg 2011; 11：213-7）
Objective: Admission hyperglycemia is associated with poor prognosis in patients with acute myocardial infarction. Final Thrombolysis in Myocardial Infarction (TIMI) frame counts of culprit coronary arteries may show significant variability despite successful coronary reperfusion after primary percutaneous coronary intervention (PCI). In this prospective observational study, relationship between final TIMI frame counts of the culprit coronary artery and admission glucose values was investigated in patients who underwent successful primary PCI due to acute ST-elevation myocardial infarction (STEMI).Methods: During a 6- month period of time, 73 non-diabetic patients presented with acute STEMI who have undergone primary PCI with final TIMI 3 flow were consecutively included in the study. Patients were divided into two groups according to final TIMI frame counts. Group 1 (n=53) consisted of patients with final TIMI frame counts of the culprit coronary artery within the two standard deviation of predefined values and Group 2 (n=20) consisted of those with higher TIMI frame counts. Statistical analysis was performed using Chi-square, Mann-Whitney U tests and multiple linear regression analysis.Results: Despite similar fasting glucose values, admission glucose levels were significantly higher in Group 2 as compared to Group 1 (138 [114-165] vs. 123 [97-143] mg/dl, p=0.03). In whole group, admission glucose values were significantly correlated with corrected TIMI frame counts of culprit coronary arteries (r=0.30, p=0.01). In addition, there were significant association between admission glucose values and peak creatine kinase-MB (r=0.36, p=0.007) values as well as left ventricular ejection fraction (r=-0.43, p=0.009). In multiple linear regression analysis, only admission glucose value was found to be significantly related to the final TIMI frame count of the culprit artery (beta=0.04, 95% Cl: 0.02-0.085, p=0.04).Conclusion: High admission glucose values were significantly associated with impaired coronary flow even after successful primary PCI in non-diabetic patients with STEMI. (Anadolu Kardiyol Derg 2011; 11:213-7)