scholarly journals Impact of Diabetes Mellitus and blood glucose levels on the results of treatment of patients with ST-elevation myocardial infarction undergoing percutaneous coronary interventions

Kardiologiia ◽  
2019 ◽  
Vol 59 (3S) ◽  
pp. 16-22 ◽  
Author(s):  
I. S. Bessonov ◽  
V. A. Kuznetsov ◽  
I. P. Ziryanov ◽  
S. S. Sapozhnikov ◽  
Yu. V. Potolinskaya
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Percutaneous Coronary Interventions ◽  
Glucose Levels ◽  
No Reflow ◽  
Results Of Treatment ◽  
Blood Glucose Levels ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
High Level

The aim of this study was to evaluate the impact of diabetes mellitus (DM) and glucose levels on the results of treatment of patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary interventions (PCIs). Materials and methods. Data were collected from all patients (n=1280) with STEMI who were admitted to the coronary care unit and underwent PCIs from 2006 to 2015. 212 (16.6%) patients with DM were compared with 1068 (83.4%) patients without DM (non-DM group). To investigate the influence of the blood glucose levels, all patients were divided into two groups above and below the median of blood glycemia (7.52 mmol/l). Results. Thus, 634 patients with high level of blood glycemia (>7.52 mmol/l) were compared with 635 patients with low level of blood glycemia (≤7.52 mmol/l). In comparing of DM and non-DM groups there were no differences in the rate of death (5.2% vs 4.2%, р=0.526), stent thrombosis (1.4% vs 1.0%, р=0.622), recurrent myocardial infarction (MI) (1.4% vs 1.2%, р=0.813) and major adverse cardiac events (MACE) (7.5% vs 5.4%, р=0.228), which included in-hospital death, recurrent MI and stent thrombosis. The rates of angiographic success (92.9% vs 93.8%, р=0.625) and no-reflow (6.6% vs 5%, р=0.327) also were comparable between groups. The rates of death (6.3% vs 2.5%, р=0.001), MACEs (7.6% vs 4.1%, р=0.008), and no-reflow (6.9% vs 3.6%, р=0,009) were significantly higher in patients with high level of blood glycemia (>7.52 mmol/l). Angiographic success rate (95.1% vs 92.1%, р=0.029) was higher in patients with low level of glycemia (≤7.52 mmol/l). After multivariate adjustment, high level of blood glycemia (>7.52 mmol/l) remained an independent predictor of death (OR=2.28; 95% CI 1.18-4.40, р=0.014), MACE (OR=2.08; 95% CI 1.16-3.75, р=0.014) and no-reflow (OR=2.07; 95% CI 1.15-3.74, р=0.015). At the same time DM wasn’t associated with death, MACE or no-reflow. Conclusion. High level of blood glycemia was an independent predictor of death, MACE and no-reflow in patients with STEMI, undergoing PCI. The presence of DM was not associated with worse in-hospital outcomes.

scholarly journals Expression of microRNA-26b-5p is related to the changes of random blood glucose after primary percutaneous coronary interventions

2020 ◽  
Author(s):  
Jianwie Zhang ◽  
Lingjie He
Keyword(s):  
Myocardial Infarction ◽  
Blood Glucose ◽  
Diabetic Patients ◽  
Circulating Microrna ◽  
Percutaneous Coronary Interventions ◽  
Spearman Correlation ◽  
Random Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Percutaneous Coronary

Abstract Background: Stress hyperglycemia （SH） is prevalent in non-diabetic patients with ST-segment elevation myocardial infarction (STEMI), and it can significantly increase the risk of adverse cardiovascular events. The study aims to determine the changes of and correlation between circulating microRNA-26b-5p levels and random blood glucose levels after primary percutaneous coronary interventions (p-PCI).Methods: INS-1 cells were used to establish model of insulin regulation. Overexpression of miR-26b was performed with lentiviral transfection, while downregulation of miR-26b was accomplished by using shRNA sequences. Insulin was quantitatively detected by an enzyme-linked immunosorbent assay kit (ELISA).we enrolled 48 patients with acute anterior wall myocardial infarction who successfully underwent p-PCI from June 2017 to November 2017 in beijing anzhen hospital and beijing friendship hospital, capital medical university. Plasma samples were collected before p-PCI, 24h and 72h after operation. The level of circulating microRNA-26b-5p were measured by Real Time PCR. The association between circulating microRNA-26b-5p and random blood glucose was calculated by Spearman correlation coefficient.Results: The results of in vitro test showed i nhibition of miR-26b leads to a decrease in insulin secretion while overexpression of miR-26b increases insulin secretion in INS-1 cells. 34 male patients accounting for 71% were included in this study. The circulating microRNA-26b-5p levels were 14.41±8.52 and 19.63±9.42 at 24h and 72h after operation respectively, as compared with 10.32±6.62 before p-PCI ( P <0.001). Significantly decreased random blood glucose level were found at 24h and 72h after operation compared with that before p-PCI（7.35±1.17 VS. 7.12±1.17 VS. 8.28±1.35, P< 0.001. Spearman correlation coefficient revealed that there was an inverse correlation between circulating microRNA-26b-5p levels and random blood glucose levels（ r =-0.425 ， P <0.001).Conclusion: MicroRNA-26b-5p may be involved in the regulation of blood glucose in non-diabetic patients with STEMI after p-PCI.

scholarly journals Percutaneous Coronary Intervention without onsite Cardiac Surgery Backup

2013 ◽  
Vol 52 (189) ◽  
pp. 267-271
Author(s):  
Laxman Dubey ◽  
Sanjib Kumar Sharma ◽  
Rabindra Bhattacharya ◽  
Sogunuru Guruprasad ◽  
Gangapatnam Subramanyam
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cardiac Surgery ◽  
Coronary Intervention ◽  
Tertiary Level ◽  
Percutaneous Coronary Interventions ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Level Hospital

Introduction: Mechanical revascularization by percutaneous coronary interventions has now become an established and preferable method of revascularization in patients with acute coronary syndromes. The aim of the study was to identify the clinical indications for percutaneous coronary interventions and in-hospital outcomes of percutaneous coronary interventions in a tertiary-level hospital without onsite cardiac surgery backup. Methods: This was a prospective descriptive study. All consecutive patients who were admitted  for percutaneous coronary interventions, including both primary as well as elective percutaneous coronary interventions, between March 2011 and December 2012 were included in the study. Results: Total 101 percutaneous coronary interventions were performed. The mean age was 58.9 ± 12.3 years. The most frequent indication was ST-elevation myocardial infarction 72 (71.3%). Proximal artery stenting were performed in 39 (38.5%) and the non proximal artery stenting in 62 (61.5%). The outcomes were mortality 5 (4.9%), periprocedural myocardial infarction 2 (1.9%), cardiogenic shock 6 (5.9%), contrast induced nephropathy requiring dialysis in 3 (2.9%), minor complications which were managed conservatively in 13 (12.9%). Conclusions: Percutaneous coronary intervention was feasible with acceptable complications in a tertiary-level hospital without onsite cardiac surgery backup. ST-elevation myocardial infarction was the major indication and cardiogenic shock was the major complication observed, and non proximal  artery stenting was more common than the proximal artery stenting. Keywords: indication; onsite cardiac surgery; outcomes; percutaneous coronary interventions.

scholarly journals Coronary microvascular obstruction (the no-reflow phenomenon) during percutaneous coronary interventions in patients with myocardial infarction

2020 ◽  
Vol 24 (1) ◽  
pp. 18
Author(s):  
A. A. Frolov ◽  
I. G. Pochinka ◽  
B. E. Shahov ◽  
E. G. Sharabrin ◽  
K. V. Kuzymichev
Keyword(s):  
Myocardial Infarction ◽  
Conflict Of Interest ◽  
Microvascular Obstruction ◽  
Negative Impact ◽  
Relevant Literature ◽  
Percutaneous Coronary Interventions ◽  
No Reflow ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
No Reflow Phenomenon

<p>Coronary microvascular obstruction (the no-reflow phenomenon) after percutaneous coronary interventions in diagnosed with myocardial infarction has a significant negative impact on both the short-term and long-term prognosis. The mechanisms underlying this disorder are heterogeneous and complex, and as such it is difficult to devise effective treatments and/or to predict specific outcomes. Modern therapeutic approaches have indirect cardioprotective effects and certainly reduce the risk of no-reflow. However, attempts to create a drug or method that fundamentally improve the prognosis in patients with coronary microvascular obstruction have been unsuccessful. Thus, the problem of myocardial reperfusion damage has not been solved and further study will be necessary to provide support for the search for new therapeutic modalities. The purpose of this review is to provide an analysis of relevant literature that focuses on the aetiology, pathogenesis, diagnosis, prognosis and treatment of the coronary microvascular obstruction during and after percutaneous coronary interventions in patients diagnosed with myocardial infarction. We searched using the Medline (PubMed), RSCI (eLIBRARY), Embase and Google Scholar databases for all relevant literature pertaining to this subject.</p><p>Received 13 January 2020. Accepted 11 February 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship. </p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals Impact of hyperglycemia on the results of percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction

2017 ◽  
Vol 89 (9) ◽  
pp. 25-29 ◽  
Author(s):  
I S Bessonov ◽  
V A Kuznetsov ◽  
Yu V Potolinskaya ◽  
I P Zyrianov ◽  
S S Sapozhnikov
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Mortality Rates ◽  
Percutaneous Coronary Interventions ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

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.

scholarly journals Circulating miR-660-5p is associated with no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention

2020 ◽  
Author(s):  
jian-wei zhang ◽  
Cheng-ping Hu ◽  
Ying-xin Zhao ◽  
Ling-jie He
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Independent Predictor ◽  
Linear Regression Analysis ◽  
Coronary Intervention ◽  
No Reflow ◽  
Timi Flow ◽  
Percutaneous Coronary ◽  
No Reflow Phenomenon

Abstract Background No-reflow phenomenon (NRP) is an important factor affecting the prognosis of patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PPCI). This study aims to investigate the association of circulating miR-660-5p with NRP in ST segment elevation myocardial infarction (STEMI) undergoing PPCI. Methods 52 eligible consecutive patients diagnosed with anterior STEMI within 12h of pain onset, which coronary angiography confirms that infarct-related artery is left anterior descending artery (LAD), were included in this study. Angiographic NRP is define as the final TIMI flow of 2 or the final TIMI flow of 3 with myocardial blush grade (MBG) of <2.Effect of circulating miR-660-5p on NRP was assessed using Spearman correlation analysis and multiple linear regression analysis. Results The incidence of NRP was 38.5%. Patients with higher miR-660-5p levels have significantly higher incidence of coronary NRP. At multivariable analysis, circulating miR-660-5p remained an independent predictor of NRP (odds ratio [OR]=1.34, 95%CI 1.10 to 1.63, p=0.004). Patients in higher microRNA-660-5p levels group have almost a 6-fold higher risk of NRP than that in lower microRNA-660-5p group (OR=5.68, 95%CI 1.40 to 23.07, p=0.015). When analyzed by tertiles, consistent trends of increasing relative odds of NRP were reported (OR1 for Q2 VS. Q1: 1.25,95%CI: 0.27-5.73, p=0.77;OR2 for Q3 VS. Q1: 5.96,95%CI: 1.33-26.66, p=0.02). Circulating miR-660-5p was related to MPV significantly. Conclusion Circulating miR-660-5p is an independent predictor of NRP in STEMI patients undergoing PPCI.

Sign in / Sign up

Export Citation Format

Share Document