Usefulness of admission blood glucose and estimated glomerular filtration rate for long-term outcomes in patients with ST-Elevation myocardial infarction undergoing primary percutaneous coronary intervention


Coskun U., Kocas C., Abaci O. , Bostan C. , Akturk F., Yildiz A., ...More

Experimental and Clinical Cardiology, vol.20, no.8, pp.3723-3731, 2014 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 8
  • Publication Date: 2014
  • Title of Journal : Experimental and Clinical Cardiology
  • Page Numbers: pp.3723-3731

Abstract

Introduction: Risk stratification is important for the management of patients with STEMI. Several studies have been carried out to identify high-risk patients. The aim of this study was to assess the value of admission blood glucose and eGFR for determining long-term prognosis in patients with STEMI undergoing PPCI. Methods: 121 consecutive ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI with onset of symptoms within 12 hours were enrolled in the study. Patients were categorized into 3 groups depending on the presence of acute hyperglycemia and impaired renal function. Group I had neither hyperglycemia nor renal dysfunction, group II had renal dysfunction or acute hyperglycemia and whereas group III had both hyperglycemia and impaired renal function. Patients were followed for at least one year for composite cardiovascular end-points, including cardiovascular death, myocardial infarction and stent thrombosis. Results: Major events occurred in 18 (14.9%) of the 121 patients. The incidence of events increased from group 1 to group 3 (9.3% (7) - %14.3 (5) - 54.5% (6), p<0.001). After adjustment for other clinical factors, combined presence of hyperglycemia and renal dysfunction remained an independent predictor for long-term adverse events (HR= 12.50, 95% confidence interval [CI] 2.495 to 24.233, p<0.001). Conclusion: In conclusion, combined use of admission hyperglycemia and eGFR had a significant distinctive capacity for predicting one-year clinical outcome in patients with STEMI undergoing primary PCI.