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The influence of admission glucose on epicardial and microvascular flow after primary angioplasty.
Chin Med J (Engl). 2006 Jan 20; 119(2):95-102.CM

Abstract

BACKGROUND

Patients with elevated admission glucose levels may be at increased risk of death after myocardial infarction, independent of other baseline risk factors and more severe coronary artery disease. However, data regarding admission glucose and epicardial and microvascular flow after primary angioplasty is limited.

METHODS

Angioplasty was performed in 308 ST-segment elevated myocardial infarction patients. Patients were divided into 3 groups on the basis of admission glucose level: group 1, < 7.8 mmol/L; group 2, (7.8 - 11.0) mmol/L; and group 3, >or= 11.0 mmol/L.

RESULTS

Compared with group 1, patients in group 2 and group 3 were more often female and older. Triglycerides (TG) in group 3 were significantly higher than group 1. At angiography, they more frequently had 2-vessel or 3-vessel disease. In the infarct-related artery, there was no relationship between hyperglycemia and thrombolysis in myocardial infarction (TIMI) 3 flow after percutaneous coronary intervention (PCI) (89.7%, 86.0% and 86.3%, P = NS). However, corrected TIMI frame count (CTFC) in group 2 and group 3 were more than group 1. TIMI myocardial perfusion grade (TMPG) 0 - 1 grade among patients with hyperglycemia after PCI were more frequent (30.9% and 29.0% vs 17.3%, P < 0.05). There was less frequent complete ST - segment resolution (STR) and early T wave inversion among patients with hyperglycemia after PCI.

CONCLUSION

Elevated admission glucose levels in ST - segment elevation myocardial infarction patients treated with primary PCI are independently associated with impaired microvascular flow. Abnormal microvascular flow may contribute at least in part to the poor outcomes observed in patients with elevated admission glucose.

Authors+Show Affiliations

Department of Cardiology, Beijing Friendship Hospital, Beijing 100050, China. shenxuhua102@yahoo.com.cnNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16454990

Citation

Shen, Xu-hua, et al. "The Influence of Admission Glucose On Epicardial and Microvascular Flow After Primary Angioplasty." Chinese Medical Journal, vol. 119, no. 2, 2006, pp. 95-102.
Shen XH, Jia SQ, Li HW. The influence of admission glucose on epicardial and microvascular flow after primary angioplasty. Chin Med J. 2006;119(2):95-102.
Shen, X. H., Jia, S. Q., & Li, H. W. (2006). The influence of admission glucose on epicardial and microvascular flow after primary angioplasty. Chinese Medical Journal, 119(2), 95-102.
Shen XH, Jia SQ, Li HW. The Influence of Admission Glucose On Epicardial and Microvascular Flow After Primary Angioplasty. Chin Med J. 2006 Jan 20;119(2):95-102. PubMed PMID: 16454990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of admission glucose on epicardial and microvascular flow after primary angioplasty. AU - Shen,Xu-hua, AU - Jia,San-qing, AU - Li,Hong-wei, PY - 2006/2/4/pubmed PY - 2006/3/17/medline PY - 2006/2/4/entrez SP - 95 EP - 102 JF - Chinese medical journal JO - Chin. Med. J. VL - 119 IS - 2 N2 - BACKGROUND: Patients with elevated admission glucose levels may be at increased risk of death after myocardial infarction, independent of other baseline risk factors and more severe coronary artery disease. However, data regarding admission glucose and epicardial and microvascular flow after primary angioplasty is limited. METHODS: Angioplasty was performed in 308 ST-segment elevated myocardial infarction patients. Patients were divided into 3 groups on the basis of admission glucose level: group 1, < 7.8 mmol/L; group 2, (7.8 - 11.0) mmol/L; and group 3, >or= 11.0 mmol/L. RESULTS: Compared with group 1, patients in group 2 and group 3 were more often female and older. Triglycerides (TG) in group 3 were significantly higher than group 1. At angiography, they more frequently had 2-vessel or 3-vessel disease. In the infarct-related artery, there was no relationship between hyperglycemia and thrombolysis in myocardial infarction (TIMI) 3 flow after percutaneous coronary intervention (PCI) (89.7%, 86.0% and 86.3%, P = NS). However, corrected TIMI frame count (CTFC) in group 2 and group 3 were more than group 1. TIMI myocardial perfusion grade (TMPG) 0 - 1 grade among patients with hyperglycemia after PCI were more frequent (30.9% and 29.0% vs 17.3%, P < 0.05). There was less frequent complete ST - segment resolution (STR) and early T wave inversion among patients with hyperglycemia after PCI. CONCLUSION: Elevated admission glucose levels in ST - segment elevation myocardial infarction patients treated with primary PCI are independently associated with impaired microvascular flow. Abnormal microvascular flow may contribute at least in part to the poor outcomes observed in patients with elevated admission glucose. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/16454990/The_influence_of_admission_glucose_on_epicardial_and_microvascular_flow_after_primary_angioplasty_ L2 - http://Insights.ovid.com/pubmed?pmid=16454990 DB - PRIME DP - Unbound Medicine ER -