PREDICTING MAJOR ADVERSE CARDIAC EVENTS AND INFARCT SIZE USING ST-SEGMENT RESOLUTION AS A CONTINUOUS RATHER THAN A DICHOTOMOUS VARIABLE IN PATIENTS ACHIEVING THROMBOLYSIS IN MYOCARDIAL INFARCTION FLOW GRADE III AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Aim. To investigate the impact of hyperglycemia on the results of percutaneous coronary interventions (PCIs) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Subjects and methods. A study group consisted of 511 patients with hyperglycemia (blood glucose level (BGL) ≥7.77 mmol/L) who underwent primary PCIs in the period from 2005 to 2015. A comparison group included 579 patients (BGL ≥7.77 mmol/L). Results. Assessment of the results of hospital interventions revealed that the mortality rates in patients with hyperglycemia proved to be higher than in those with normal BGL (6.5 and 2.6%, respectively; p=0.002). No differences were found in the rates of stent thrombosis (1 and 1.4%; p=0.541) and recurrent myocardial infarction (1.2 and 1.6%; p=0.591). Major adverse cardiac events, including death, recurrent infarction, and stent thrombosis, were more frequently determined in the hyperglycemic patients (7.6 and 4.3%; p=0.020). No-reflow phenomenon statistically significantly more frequently developed in the patients with hyperglycemia (6.8 and 3.3%; p=0.007). Binary logistic regression analysis showed that the presence of hyperglycemia served as an independent predictor of hospital mortality (odds ratio (OR) 2.6; 95% confidence interval (CI), 1.4 to 4.8; p=0.002). The application of a random probability sampling technique revealed that mortality remained statistically significantly higher in the hyperglycemic patients than in the normoglycemic individuals at admission (6.7 and 2.6%; р=0.011). Conclusion. PCIs in patients with ASTEMI and hyperglycemia are characterized by higher mortality rates and the risk of major adverse cardiac events. Admission hyperglycemia is an independent predictor of hospital mortality.

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Eosinophil percentage as a new prognostic marker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Interventional Medicine and Applied Science ◽

10.1556/1646.11.2019.17 ◽

2020 ◽

Vol 11 (3) ◽

pp. 146-153

Author(s):

Ahmet Güner ◽

Regayİp Zehİr ◽

Macİt KalçIk ◽

Abdulkadİr Uslu ◽

Altuğ Ösken ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Intervention ◽

Inhospital Mortality ◽

Cardiac Events ◽

St Segment Elevation ◽

Target Vessel Revascularization ◽

Segment Elevation Myocardial Infarction ◽

Group 4 ◽

St Segment ◽

Adverse Cardiac Events

Background In addition to proinflammatory properties, eosinophils can stimulate platelet activation and enhance prothrombotic pathways. In this study, we aimed to investigate the association between the eosinophil percentage (EOS%) and major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods This study enrolled a total of 1,909 patients who were diagnosed with STEMI. Ventricular arrhythmia, reinfarction, the need for cardiopulmonary resuscitation, target vessel revascularization, congestive heart failure, and cardiovascular mortality during index hospitalization were defined as MACE. Results Three hundred and eighty patients (19.7%) reached the combined endpoint with MACE. The rates of inhospital mortality and MACE were significantly higher in low EOS% group as compared to high EOS% group (4% vs. 1.1%, p < 0.01 and 32.8% vs. 11.3%, p < 0.01, respectively). On multivariate logistic regression analyses, EOS% (OR = 0.44, p < 0.01) was found to be one of the independent predictors of MACE. The EOS% lower than 0.60 on admission predicted inhospital MACE with a sensitivity of 68% and a specificity of 72% (AUC: 0.684, p < 0.01). Conclusions Low EOS% on admission may be associated with high inhospital MACE in STEMI patients. EOS% may be used as a novel biomarker for risk stratification of these patients.

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