The relation between blood glucose on admission with angiographic no-reflow in patients with st elevation myocardial infarction

Introduction and purpose: Coronary artery disease is the most common cause of death in the world. We investigated the association between hyperglycemia and the no-reflow phenomenon in patients with Acute ST-Elevation Myocardial Infarction (STEMI). Hyperglycemia is associated with increased risks of heart failure, cardiogenic shock, and death after STEMI, but its underlying mechanism remains unknown. Materials and methods: We analyzed 900 retrospective consecutive patients admitted for STEMI to the Coronary Care Unit of Dicle Universiy Heart Hospital. All patients in the intensive care unit admission, serum blood glucose levels with other laboratory parameters were measured. We defined angiographic no-reflow phenomenon as a coronary TIMI flow grade ≤2 after vessel re-canalized. Patients were grouped into reflow and no-reflow. All data were documented. Results: A total of 372 patients who underwent p-PCI were enrolled in the study. 70 patients (19%) was included in the no-reflow group, 302 patients (81%) were included in the reflow group. The mean age was 60.9 ± 13.7 in the reflow group, the no-reflow group was 66.1 ± 13.4 years (p=0.005). Admission mean blood glucose level in no-reflow group was 199.7 ± 106.9 mg/dl, in the reflow group was 163.8 ± 71.1 mg/dl (p=0.001). By stepwise forward multivariate logistic regression analysis; age (p=0.001), Killip class (p=0.010), admission blood glucose levels (p=0.038), MPV (p=0.039) and neutrophil counts (p=0.030) were shown to be independent predictors noreflow. Conclusions: In patients presenting with STEMI application was a significant association between a high level of blood sugar on admission with no-reflow phenomenon. High blood glucose level on admission, can be considered as an independent predictor of no-reflow phenomenon. Application in patients presenting with STEMI done studies showing no-reflow phenomenon can be reduced by lowering blood glucose level.