Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Gray/Bigelow 800, Boston, MA 02114, USA.
Diabetes Res Clin Pract. 2010 Apr;88(1):97-102. doi: 10.1016/j.diabres.2010.01.001. Epub 2010 Jan 18.
To determine if hyperglycemia on admission correlates to infarct size measured by single-photon emission computed tomography (SPECT) in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).
We evaluated 347 STEMI patients who underwent primary PCI. Infarct size was determined by SPECT on Day 5. The population was divided into: hyperglycemia (glycemia on admission >11mmol/L) or non-hyperglycemia (<or=11mmol/L) regardless of diabetic status.
61 (17.6%) patients presented with hyperglycemia on admission. There were no significant differences in baseline characteristics or in PCI characteristics between the two groups. Final TIMI 3 flow was achieved in 81.7% of patients with hyperglycemia vs 85.7% of patients with non-hyperglycemia (p=0.43). The infarct size was larger in the hyperglycemia group (6 [2-14]% vs 8.5 [3-18.25]%; p=0.016). A multivariate linear regression analysis showed that hyperglycemia on admission was an independent predictor of infarct size at Day 5 post-MI (p=0.004).
In patients with STEMI treated with primary PCI, hyperglycemia on admission is associated with larger infarct size determined by SPECT.
确定入院时的高血糖是否与接受直接经皮冠状动脉介入治疗（PCI）的急性 ST 段抬高型心肌梗死（STEMI）患者的单光子发射计算机断层扫描（SPECT）测量的梗死面积相关。
我们评估了 347 例接受直接 PCI 的 STEMI 患者。梗死面积通过 SPECT 在第 5 天确定。人群分为：高血糖（入院时血糖>11mmol/L）或非高血糖（<=11mmol/L），无论是否合并糖尿病。
61 例（17.6%）患者入院时存在高血糖。两组患者的基线特征或 PCI 特征均无显著差异。高血糖组终末 TIMI 3 血流的获得率为 81.7%，而非高血糖组为 85.7%（p=0.43）。高血糖组的梗死面积较大（6 [2-14]% vs 8.5 [3-18.25]%；p=0.016）。多变量线性回归分析显示，入院时的高血糖是心肌梗死后第 5 天 SPECT 测量的梗死面积的独立预测因子（p=0.004）。
在接受直接 PCI 治疗的 STEMI 患者中，入院时的高血糖与 SPECT 测定的更大梗死面积相关。
