The association of acute-to-chronic glycemic ratio with no-reflow in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Abstract:

BACKGROUND:No-reflow (NR) is a strong and independent predictor of poor cardiovascular outcomes among ST elevation myocardial infarction (STEMI) patients. AIMS:To investigate the association of acute-to-chronic (A/C) glycemic ratio with no-reflow (NR) development in STEMI patients following primary percutaneous coronary intervention (PCI). METHODS:This retrospective study included 905 STEMI patients. The A/C glycemic ratio was determined as admission blood glucose (ABG) divided by the estimated average glucose (eAG). We evaluated two primary models (full model and reduced model). The primary outcome was the presence of NR. RESULTS:The incidence of NR was 22.7% (206 cases) in the present study. We divided the study population into three tertiles (T1, T2, and T3) based on the ABG/eAG ratio. There was a stepwise increase of the frequency of NR development from the T1 to T3 group (36 patients [12%] vs. 70 patients [23%] vs. 100 patients [33%]; respectively [P < 0.001, for each group comparison]). In a full model, the ABG/eAG ratio (OR; 2.274, 95% CI; 1.587-3.26, P < 0.001) was associated with NR. After the performance of a step-down backward variable selection method, the thrombus grade, the ABG/eAG ratio, the infarct-related artery diameter, and age remained in the reduced model. The ABG/eAG ratio (contributing 25.3% of the explainable outcome in the model) was one of the strong predictors of NR in the reduced model. CONCLUSIONS:To our knowledge, this might be the first study showing a significant relationship between the ABG/eAG ratios with NR in STEMI patients after primary PCI.

journal_name

Kardiol Pol

journal_title

Kardiologia polska

authors

Şimşek B,Çınar T,Ozan V,İnan TD,Zeren G,Avcı İİ,Güngör B,Yılmaz F,Tanboğa İH,Karabay CY

doi

10.33963/KP.15736

subject

Has Abstract

pub_date

2020-12-31 00:00:00

eissn

0022-9032

issn

1897-4279

pub_type

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