[Glucose level on admission and outcome after primary percutaneous coronary intervention in patients with acute myocardial infarction].

Objective: To investigate the influence of elevated glucose level on epicardial/microvascular flow and survival in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

Methods: A total of 308 patients with STEMI underwent primary PCI were divided into 3 groups according to the glucose level on admission: group 1, < 7.8 mmol/L; group 2, 7.8-11.0 mmol/L, and group 3, > or = 11.0 mmol/L.

Results: Compared with group 1, patients in the group 2 and 3 were older, had higher triglycerides levels and more 2-vessel or 3-vessel diseases. Although TIMI flow after PCI were similar among groups (89.7%, 86.0% and 86.3%, P = > 0.05), corrected TIMI frame count (CTFC) in group 2 and group 3 were higher than that in group 1. Moreover, TIMI myocardial perfusion grade (TMPG) 0-1 grade rate post PCI was higher in group 2 and 3 (30.3% and 29.0%) than that of group 1 (17.3%, P < 0.05). There was less frequently complete ST-segment resolution (56.7%) and early T wave inversion (58.3%) in group 3 than that of group 1 after PCI (72.0% and 73.4% respectively, P < 0.05). Mortality rate at 30 days post PCI was significantly higher in the group 3 (10.4%) than that in the group 1 (2.6%, P < 0.05).

Conclusion: Elevated glucose level on admission in ST-segment elevation myocardial infarction patients treated with primary PCI is associated with reduced myocardial microvascular flow. Abnormal myocardial microvascular flow might contribute to the poor outcomes observed in patients with hyperglycemia on admission.