Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention
Abstract Background The combined effects of diabetes mellitus (DM), admission plasma glucose (APG), and glycated hemoglobin (HbA1c) levels on predicting long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventi...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-020-01339-x |
| _version_ | 1818915218420400128 |
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| author | Yan Li Xiaowen Li Yinhua Zhang Leimin Zhang Qingqing Wu Zhaorun Bai Jin Si Xuebing Zuo Ning Shi Jing Li Xi Chu |
| author_facet | Yan Li Xiaowen Li Yinhua Zhang Leimin Zhang Qingqing Wu Zhaorun Bai Jin Si Xuebing Zuo Ning Shi Jing Li Xi Chu |
| author_sort | Yan Li |
| collection | DOAJ |
| description | Abstract Background The combined effects of diabetes mellitus (DM), admission plasma glucose (APG), and glycated hemoglobin (HbA1c) levels on predicting long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) are unknown. Therefore, we evaluated their combined effects on long-term clinical outcomes in STEMI patients treated with pPCI. Methods In total, 350 consecutive patients with STEMI undergoing pPCI were enrolled. Patients were divided into 3 groups according to DM history and APG and HbA1c levels. The cumulative rates of 24-month all-cause deaths and major adverse cardiac and cerebrovascular events (MACCEs) were calculated. Results Both the incidence of all-cause deaths and cumulative rates of MACCEs were significantly the lowest in patients without a DM history and admission HbA1c level < 6.5%. DM patients with poor glycemic control or stress hyperglycemia on admission experienced the highest rates of all-cause deaths, MACCEs, and cardiac deaths. Admission HbA1c levels, Triglyceride (TG) levels, hemoglobin levels, DM history, and admission Killip class > 1 correlated with 24-month all-cause death; HbA1c levels on admission, DM history, APG levels, history of stroke, history of coronary heart disease, and TG levels on admission were significantly associated with MACCEs through the 24-month follow-up. The predictive effects of combining DM and APG and HbA1c levels were such that for STEMI patients undergoing pPCI, DM patients with poor glycemic control or with stress hyperglycemia on admission had worse prognosis than other patients. Conclusion Strict control of glycemic status may improve the survival of patients who have both DM and coronary heart diseases. |
| first_indexed | 2024-12-19T23:58:47Z |
| format | Article |
| id | doaj.art-3cbf1dcbdaac43f9b7c3b8c723eb5b3f |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-19T23:58:47Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-3cbf1dcbdaac43f9b7c3b8c723eb5b3f2022-12-21T20:00:54ZengBMCBMC Cardiovascular Disorders1471-22612020-01-012011810.1186/s12872-020-01339-xImpact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary interventionYan Li0Xiaowen Li1Yinhua Zhang2Leimin Zhang3Qingqing Wu4Zhaorun Bai5Jin Si6Xuebing Zuo7Ning Shi8Jing Li9Xi Chu10Departent of Cardiology, Xuanwu hospital, Capital Medical UniversityEmergency Department, Aerospace Center HospitalDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityDepartment of internal medicine, Qinghe Substation Hospital of Beijing Municipal Administration of PrisonsDepartment of Cardiology, Beijing Luhe Hospital, Capital Medical UniversityDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityDepartent of Cardiology, Xuanwu hospital, Capital Medical UniversityHealth Management Center, Xuanwu hospital, Capital Medical UniversityAbstract Background The combined effects of diabetes mellitus (DM), admission plasma glucose (APG), and glycated hemoglobin (HbA1c) levels on predicting long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) are unknown. Therefore, we evaluated their combined effects on long-term clinical outcomes in STEMI patients treated with pPCI. Methods In total, 350 consecutive patients with STEMI undergoing pPCI were enrolled. Patients were divided into 3 groups according to DM history and APG and HbA1c levels. The cumulative rates of 24-month all-cause deaths and major adverse cardiac and cerebrovascular events (MACCEs) were calculated. Results Both the incidence of all-cause deaths and cumulative rates of MACCEs were significantly the lowest in patients without a DM history and admission HbA1c level < 6.5%. DM patients with poor glycemic control or stress hyperglycemia on admission experienced the highest rates of all-cause deaths, MACCEs, and cardiac deaths. Admission HbA1c levels, Triglyceride (TG) levels, hemoglobin levels, DM history, and admission Killip class > 1 correlated with 24-month all-cause death; HbA1c levels on admission, DM history, APG levels, history of stroke, history of coronary heart disease, and TG levels on admission were significantly associated with MACCEs through the 24-month follow-up. The predictive effects of combining DM and APG and HbA1c levels were such that for STEMI patients undergoing pPCI, DM patients with poor glycemic control or with stress hyperglycemia on admission had worse prognosis than other patients. Conclusion Strict control of glycemic status may improve the survival of patients who have both DM and coronary heart diseases.https://doi.org/10.1186/s12872-020-01339-xST-segment elevation myocardial infarctionHyperglycemiaDiabetesGlycated hemoglobinPercutaneous coronary intervention |
| spellingShingle | Yan Li Xiaowen Li Yinhua Zhang Leimin Zhang Qingqing Wu Zhaorun Bai Jin Si Xuebing Zuo Ning Shi Jing Li Xi Chu Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention BMC Cardiovascular Disorders ST-segment elevation myocardial infarction Hyperglycemia Diabetes Glycated hemoglobin Percutaneous coronary intervention |
| title | Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| title_full | Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| title_fullStr | Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| title_full_unstemmed | Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| title_short | Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| title_sort | impact of glycemic control status on patients with st segment elevation myocardial infarction undergoing percutaneous coronary intervention |
| topic | ST-segment elevation myocardial infarction Hyperglycemia Diabetes Glycated hemoglobin Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s12872-020-01339-x |
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