Background: Blood glucose level at admission in ST-segment elevation myocardial infarction (STEMI) is a predictor of heart failure and mortality. This study was performed to investigate the impact of hyperglycemia at admission in non-diabetic patients on infarct size, microvascular obstruction, and long-term outcome using contrast-enhanced magnetic resonance imaging (CMR) in patients with acute STEMI.
Methods: One hundred and seven consecutive patients (84 males; mean age 59.4 years ± 11.3 years) with a first acute STEMI successfully treated by primary PCI were included. Admission hyperglycemia was defined as blood glucose above 7.8 mmol/l. CMR was performed 3.6 days ± 1.9 days after admission on a 1.5-tesla MR system. The imaging protocol included single-shot steady-state free precession (SSFP) cine sequences for assessing segmental and global left ventricular (LV) function and microvascular obstruction (MVO)/late gadolinium enhancement (LGE) imaging immediately and 10 min after the administration of 0.2 mmol gadodiamide/kg of body weight using an inversion-recovery SSFP (IR-SSFP) sequence. A receiver operating characteristics analysis was used to detect the best cut-off point of microvascular obstruction that predicted myocardial infarction and death during follow-up.
Results: Of 107 patients, 37 (35%) had hyperglycemia on admission. Compared to normoglycemic patients, patients with admission hyperglycemia had a lower LV ejection fraction (38.6 ± 13.7% vs. 47.5 ± 12.2%, p < 0.001), greater ESV (88.8 ± 41.8 ml vs. 72.3 ml ± 35.1 ml, p = 0.01), greater infarct size (LGE% 21.1 ± 14.9% vs. 9.8 ± 8.7%, p < 0.001), and greater MVO (MVO% 9.6 ± 9.9% vs. 2.5 ± 4.3%, p < 0.001). Admission hyperglycemia was an independent predictor of the presence and extent of microvascular obstruction. Microvascular obstruction as a percentage of left ventricular mass was the only variable independently related to clinical outcome in a Cox proportional hazard model (Wald 18.78, HR 1.155, p < 0.001).
Conclusion: Hyperglycemia at admission in STEMI patients who are successfully treated by PCI is independently associated with the presence and extent of microvascular obstruction on contrast-enhanced CMR. Thus, microvascular obstruction as assessed by CMR may be a mechanism that relates admission hyperglycemia in acute STEMI to worse outcome.
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http://dx.doi.org/10.1007/s00392-011-0290-7 | DOI Listing |
Eur J Med Res
January 2025
Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, No. 176 Qingnian Road, Wuhua District, Kunming, Yunnan, China.
Background: Stress hyperglycemia ratio (SHR) has been linked to prognosis of cerebrovascular diseases. Nevertheless, the association between SHR and severe disturbance of consciousness (DC) and mortality among patients with cerebral infarction remains explored. This study seeks to assess the predictive potential of SHR for severe DC and mortality among patients with cerebral infarction.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Editorial Board of Jiangsu Medical Journal, the First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China.
Background: Gestational diabetes mellitus is hyperglycemia in special populations (pregnant women), however gestational diabetes mellitus (GDM) not only affects maternal health, but also has profound effects on offspring health. The prevalence of gestational diabetes in my country is gradually increasing.
Objective: To study the application effect of self-transcendence nursing model in GDM patients.
Interv Neuroradiol
January 2025
Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA.
Background: The impact of certain comorbidities on mechanical thrombectomy (MT) outcomes remains largely unexplored. Diabetes mellitus (DM) and admission hyperglycemia have been associated with poor clinical outcomes for patients treated with MT. In this study, we sought to investigate the effects of DM and admission hyperglycemia on MT outcomes.
View Article and Find Full Text PDFCan J Hosp Pharm
January 2025
, PharmD, is with the Graduate Program in Sciences Applied to Women's Health, Maternidade Escola Januário Cicco, and the Graduate Program of Pharmaceutical Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil.
Background: Pregnant people, especially those with diabetes mellitus or hypertension, are particularly vulnerable to adverse drug reactions (ADRs).
Objective: To determine the incidence of and factors associated with ADRs in hospitalized pregnant people with diabetes and/or hypertension.
Methods: This prospective cohort study involved pregnant people with diabetes and/or hypertension admitted to a maternity hospital in Natal, Brazil, between August 2019 and July 2022.
BMJ Open
January 2025
Department of Diabetes and Endocrinology, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.
Introduction: Stress hyperglycaemia at hospital presentation is associated with poorer outcomes. Less is known about the risk of poorer outcomes according to achieved glycaemia early in the admission.
Research Design/methods: This was a retrospective observational study of patients admitted to non-critical care wards.
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