[The effect of admission hyperglycemia on coronary reflow in primary percutaneous coronary intervention].

ABSTRACT

OBJECTIVE: To assess the association between admission plasma glucose (APG) and no-reflow during primary percutaneous coronary intervention (PCI) in patients with ST-elevation acute myocardial infarction (STEMI). METHODS: A total of 1413 patients with STEMI successfully treated with PCI were divided into no-reflow group and normal reflow group. RESULTS: The no-reflow was found in 297 patients (21.0%) of 1413 patients; their APG level was significantly higher than that of the normal reflow group [(13.80 ± 7.47) vs (9.67 ± 5.79) mmol/L, P < 0.0001]. Multivariate logistic regression analysis revealed that current smoking (OR 1.146, 95%CI 1.026 - 1.839, P = 0.031), hyperlipidemia (OR 1.082, 95%CI 1.007 - 1.162, P = 0.032), long reperfusion (> 6 h, OR 1.271, 95%CI 1.158 - 1.403, P = 0.001), admission creatinine clearance (< 90 ml/min, OR 1.046, 95%CI 1.007 - 1.086, P = 0.020), IABP use before PCI (OR 9.346, 95%CI 1.314 - 67.199, P = 0.026), and APG (> 13.0 mmol/L, OR 1.269, 95%CI 1.156 - 1.402, P = 0.027) were the independent no-reflow predictors. The no-reflow incidence was increased as APG increased (14.6% in patients with APG < 7.8 mmol/L and 36.7% in patients with APG > 13.0 mmol/L, P = 0.009). CONCLUSION: APG > 13.0 mmol/L is an independent no-reflow predictor in patients with STEMI and PPCI.