Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA
Abstract Background Hyperglycemia has been associated with increased inflammatory indexes and larger infarct sizes in patients with obstructive acute myocardial infarction (obs-AMI). In contrast, no studies have explored these correlations in non-obstructive acute myocardial infarction (MINOCA). We...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-021-01222-9 |
| _version_ | 1818623305796550656 |
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| author | Pasquale Paolisso Alberto Foà Luca Bergamaschi Francesco Donati Michele Fabrizio Chiara Chiti Francesco Angeli Sebastiano Toniolo Andrea Stefanizzi Matteo Armillotta Paola Rucci Gianmarco Iannopollo Gianni Casella Cinzia Marrozzini Nazzareno Galiè Carmine Pizzi |
| author_facet | Pasquale Paolisso Alberto Foà Luca Bergamaschi Francesco Donati Michele Fabrizio Chiara Chiti Francesco Angeli Sebastiano Toniolo Andrea Stefanizzi Matteo Armillotta Paola Rucci Gianmarco Iannopollo Gianni Casella Cinzia Marrozzini Nazzareno Galiè Carmine Pizzi |
| author_sort | Pasquale Paolisso |
| collection | DOAJ |
| description | Abstract Background Hyperglycemia has been associated with increased inflammatory indexes and larger infarct sizes in patients with obstructive acute myocardial infarction (obs-AMI). In contrast, no studies have explored these correlations in non-obstructive acute myocardial infarction (MINOCA). We investigated the relationship between hyperglycemia, inflammation and infarct size in a cohort of AMI patients that included MINOCA. Methods Patients with AMI undergoing coronary angiography between 2016 and 2020 were enrolled. The following inflammatory markers were evaluated: C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-platelet ratio (NPR). Myocardial infarct size was measured by peak high sensitivity troponin I (Hs-TnI) levels, left-ventricular-end-diastolic-volume (LVEDV) and left ventricular ejection fraction (LVEF). Results The final study population consisted of 2450 patients with obs-AMI and 239 with MINOCA. Hyperglycemia was more prevalent among obs-AMI cases. In all hyperglycemic patients—obs-AMI and MINOCA—NLR, NPR, and LPR were markedly altered. Hyperglycemic obs-AMI subjects exhibited a higher Hs-TnI (p < 0.001), a larger LVEDV (p = 0.003) and a lower LVEF (p < 0.001) compared to normoglycemic ones. Conversely, MINOCA patients showed a trivial myocardial damage, irrespective of admission glucose levels. Conclusions Our data confirm the association of hyperglycemic obs-AMI with elevated inflammatory markers and larger infarct sizes. MINOCA patients exhibited modest myocardial damage, regardless of admission glucose levels. |
| first_indexed | 2024-12-16T18:38:57Z |
| format | Article |
| id | doaj.art-53f56a0aa95e4cd0b11f42b5040dc2df |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-16T18:38:57Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-53f56a0aa95e4cd0b11f42b5040dc2df2022-12-21T22:21:06ZengBMCCardiovascular Diabetology1475-28402021-02-0120111110.1186/s12933-021-01222-9Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCAPasquale Paolisso0Alberto Foà1Luca Bergamaschi2Francesco Donati3Michele Fabrizio4Chiara Chiti5Francesco Angeli6Sebastiano Toniolo7Andrea Stefanizzi8Matteo Armillotta9Paola Rucci10Gianmarco Iannopollo11Gianni Casella12Cinzia Marrozzini13Nazzareno Galiè14Carmine Pizzi15Unit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaDivision of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of BolognaUnit of Cardiology, Maggiore HospitalUnit of Cardiology, Maggiore HospitalUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaUnit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of BolognaAbstract Background Hyperglycemia has been associated with increased inflammatory indexes and larger infarct sizes in patients with obstructive acute myocardial infarction (obs-AMI). In contrast, no studies have explored these correlations in non-obstructive acute myocardial infarction (MINOCA). We investigated the relationship between hyperglycemia, inflammation and infarct size in a cohort of AMI patients that included MINOCA. Methods Patients with AMI undergoing coronary angiography between 2016 and 2020 were enrolled. The following inflammatory markers were evaluated: C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-platelet ratio (NPR). Myocardial infarct size was measured by peak high sensitivity troponin I (Hs-TnI) levels, left-ventricular-end-diastolic-volume (LVEDV) and left ventricular ejection fraction (LVEF). Results The final study population consisted of 2450 patients with obs-AMI and 239 with MINOCA. Hyperglycemia was more prevalent among obs-AMI cases. In all hyperglycemic patients—obs-AMI and MINOCA—NLR, NPR, and LPR were markedly altered. Hyperglycemic obs-AMI subjects exhibited a higher Hs-TnI (p < 0.001), a larger LVEDV (p = 0.003) and a lower LVEF (p < 0.001) compared to normoglycemic ones. Conversely, MINOCA patients showed a trivial myocardial damage, irrespective of admission glucose levels. Conclusions Our data confirm the association of hyperglycemic obs-AMI with elevated inflammatory markers and larger infarct sizes. MINOCA patients exhibited modest myocardial damage, regardless of admission glucose levels.https://doi.org/10.1186/s12933-021-01222-9HyperglycemiaInflammationInfarct sizeMINOCAObstructive acute myocardial infarction |
| spellingShingle | Pasquale Paolisso Alberto Foà Luca Bergamaschi Francesco Donati Michele Fabrizio Chiara Chiti Francesco Angeli Sebastiano Toniolo Andrea Stefanizzi Matteo Armillotta Paola Rucci Gianmarco Iannopollo Gianni Casella Cinzia Marrozzini Nazzareno Galiè Carmine Pizzi Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA Cardiovascular Diabetology Hyperglycemia Inflammation Infarct size MINOCA Obstructive acute myocardial infarction |
| title | Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA |
| title_full | Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA |
| title_fullStr | Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA |
| title_full_unstemmed | Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA |
| title_short | Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA |
| title_sort | hyperglycemia inflammatory response and infarct size in obstructive acute myocardial infarction and minoca |
| topic | Hyperglycemia Inflammation Infarct size MINOCA Obstructive acute myocardial infarction |
| url | https://doi.org/10.1186/s12933-021-01222-9 |
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