Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction
Abstract Background Stress induced hyperglycemia (SIH) is common among patients with ST-elevation myocardial infarction (STEMI), even in patients without diabetes mellitus. However, evidence regarding its role on the angiographic outcomes and the prognosis of patients presenting with STEMI is scarce...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01578-6 |
| _version_ | 1811222335042093056 |
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| author | Nikolaos Stalikas Andreas S. Papazoglou Efstratios Karagiannidis Eleftherios Panteris Dimitrios Moysidis Stylianos Daios Vasileios Anastasiou Vasiliki Patsiou Triantafyllia Koletsa George Sofidis Georgios Sianos George Giannakoulas |
| author_facet | Nikolaos Stalikas Andreas S. Papazoglou Efstratios Karagiannidis Eleftherios Panteris Dimitrios Moysidis Stylianos Daios Vasileios Anastasiou Vasiliki Patsiou Triantafyllia Koletsa George Sofidis Georgios Sianos George Giannakoulas |
| author_sort | Nikolaos Stalikas |
| collection | DOAJ |
| description | Abstract Background Stress induced hyperglycemia (SIH) is common among patients with ST-elevation myocardial infarction (STEMI), even in patients without diabetes mellitus. However, evidence regarding its role on the angiographic outcomes and the prognosis of patients presenting with STEMI is scarce. Methods This study included 309 consecutively enrolled STEMI patients undergoing primary percutaneous coronary intervention (pPCI). Patients were diagnosed with SIH if blood glucose on admission was > 140 mg/dl. Also, patients had to fast for at least 8 hours before blood sampling. The objective was to assess whether SIH was associated with major adverse cardiovascular and cerebrovascular (MACCE) events and explore its relationship with angiographic predictors of worse prognosis such as poor initial TIMI flow, intracoronary thrombus burden, distal embolization, and presence of residual thrombus after pPCI. Results SIH in diabetic and non-diabetic patients was associated with a higher incidence of LTB (aOR = 2.171, 95% CI 1.27–3.71), distal embolization (aOR = 2.71, 95% CI 1.51–4.86), and pre-procedural TIMI flow grade = 0 (aOR = 2.69, 95% CI 1.43–5.04) after adjusting for relevant clinical variables. Importantly, during a median follow-up of 1.7 years STEMI patients with SIH with or without diabetes experienced increased occurrence of MACCE both in univariate (HR = 1.92, 95% CI 1.19–3.01) and multivariate analysis (aHR = 1.802, 95% CI 1.01–3.21). Conclusions SIH in STEMI patients with or without diabetes was independently associated with increased MACCE. This could be attributed to the fact that SIH was strongly correlated with poor pre-procedural TIMI flow, LTB, and distal embolization. Large clinical trials need to validate SIH as an independent predictor of adverse angiographic and clinical outcomes to provide optimal individualized care for patients with STEMI. |
| first_indexed | 2024-04-12T08:14:06Z |
| format | Article |
| id | doaj.art-09e4e88b2f8146938901b8753417fe76 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-12T08:14:06Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-09e4e88b2f8146938901b8753417fe762022-12-22T03:40:51ZengBMCCardiovascular Diabetology1475-28402022-07-012111810.1186/s12933-022-01578-6Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarctionNikolaos Stalikas0Andreas S. Papazoglou1Efstratios Karagiannidis2Eleftherios Panteris3Dimitrios Moysidis4Stylianos Daios5Vasileios Anastasiou6Vasiliki Patsiou7Triantafyllia Koletsa8George Sofidis9Georgios Sianos10George Giannakoulas11First Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiLaboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiPathology Department, Faculty of Medicine, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiAbstract Background Stress induced hyperglycemia (SIH) is common among patients with ST-elevation myocardial infarction (STEMI), even in patients without diabetes mellitus. However, evidence regarding its role on the angiographic outcomes and the prognosis of patients presenting with STEMI is scarce. Methods This study included 309 consecutively enrolled STEMI patients undergoing primary percutaneous coronary intervention (pPCI). Patients were diagnosed with SIH if blood glucose on admission was > 140 mg/dl. Also, patients had to fast for at least 8 hours before blood sampling. The objective was to assess whether SIH was associated with major adverse cardiovascular and cerebrovascular (MACCE) events and explore its relationship with angiographic predictors of worse prognosis such as poor initial TIMI flow, intracoronary thrombus burden, distal embolization, and presence of residual thrombus after pPCI. Results SIH in diabetic and non-diabetic patients was associated with a higher incidence of LTB (aOR = 2.171, 95% CI 1.27–3.71), distal embolization (aOR = 2.71, 95% CI 1.51–4.86), and pre-procedural TIMI flow grade = 0 (aOR = 2.69, 95% CI 1.43–5.04) after adjusting for relevant clinical variables. Importantly, during a median follow-up of 1.7 years STEMI patients with SIH with or without diabetes experienced increased occurrence of MACCE both in univariate (HR = 1.92, 95% CI 1.19–3.01) and multivariate analysis (aHR = 1.802, 95% CI 1.01–3.21). Conclusions SIH in STEMI patients with or without diabetes was independently associated with increased MACCE. This could be attributed to the fact that SIH was strongly correlated with poor pre-procedural TIMI flow, LTB, and distal embolization. Large clinical trials need to validate SIH as an independent predictor of adverse angiographic and clinical outcomes to provide optimal individualized care for patients with STEMI.https://doi.org/10.1186/s12933-022-01578-6STEMIStress induced hyperglycemiaDiabetesThrombusDistal embolization |
| spellingShingle | Nikolaos Stalikas Andreas S. Papazoglou Efstratios Karagiannidis Eleftherios Panteris Dimitrios Moysidis Stylianos Daios Vasileios Anastasiou Vasiliki Patsiou Triantafyllia Koletsa George Sofidis Georgios Sianos George Giannakoulas Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction Cardiovascular Diabetology STEMI Stress induced hyperglycemia Diabetes Thrombus Distal embolization |
| title | Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction |
| title_full | Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction |
| title_fullStr | Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction |
| title_full_unstemmed | Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction |
| title_short | Association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with ST-elevation myocardial infarction |
| title_sort | association of stress induced hyperglycemia with angiographic findings and clinical outcomes in patients with st elevation myocardial infarction |
| topic | STEMI Stress induced hyperglycemia Diabetes Thrombus Distal embolization |
| url | https://doi.org/10.1186/s12933-022-01578-6 |
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