Zufei Wu, Wentao Su, Chen Shi, Xu Bai Da, Zong Gang Jun, Wu Gang-Yong
Department of Cardiology, The 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, China.
Department of Cardiology, Xuancheng People's Hospital, Xuanchen, Anhui, China.
Front Cardiovasc Med. 2024 Dec 3;11:1478743. doi: 10.3389/fcvm.2024.1478743. eCollection 2024.
Coronary slow flow (CSF) is a common phenomenon of coronary microcirculation dysfunction, and is closely related to elevated blood glucose and fibrinogen (FIB) levels. However, whether immediate blood glucose and FIB levels affect coronary blood flow during primary percutaneous coronary intervention (PCI) remains unclear.
To explore the correlation between admission blood glucose (ABG), fibrinogen (FIB) and slow blood flow during primary PCI for acute ST segment elevation myocardial infarction (STEMI).
A total of 497 patients who underwent coronary angiography in the cardiology department of the 904th Hospital of the Joint Logistics Support Force from December 2018 to December 2022 due to STEMI were selected consecutively, and then were divided into two groups based on whether slow blood flow occurred during primary PCI: slow blood flow group ( = 117) and control group ( = 380). Detecting the ABG, FIB and other indicators of patients in each group, and using logistic regression analysis and receiver operating characteristic (ROC) curve to analyze independent risk factors for slow blood flow during primary PCI, and further evaluating the prognosis of patients.
The levels of ABG and FIB in patients with slow blood flow were significantly higher than those in the control group ( < 0.05). The results of multivariate logistic regression analysis suggested that FIB and ABG were independent risk factors for slow blood flow during primary PCI (both < 0.05). ROC curve analysis showed that ABG, FIB, and their combination all had predictive value for slow blood flow during primary PCI (all < 0.05), and the area under the curve (AUC) of the combined indicator was higher than that of any single indicator, with statistical significance ( < 0.05). KM curve analysis suggested that the prognosis of patients in slow blood flow group were poor.
Both elevated ABG and FIB could predict slow blood flow during primary PCI, and the diagnostic value of the combined indicator was superior to that of any single indicator, which could be used for the evaluation of slow blood flow during primary PCI, so as to evaluate the prognosis of patients with STEMI.
冠状动脉血流缓慢（CSF）是冠状动脉微循环功能障碍的常见现象，与血糖和纤维蛋白原（FIB）水平升高密切相关。然而，在直接经皮冠状动脉介入治疗（PCI）期间即时血糖和FIB水平是否影响冠状动脉血流仍不清楚。
探讨急性ST段抬高型心肌梗死（STEMI）患者直接PCI术中入院血糖（ABG）、纤维蛋白原（FIB）与血流缓慢之间的相关性。
连续选取2018年12月至2022年12月在联勤保障部队第904医院心内科因STEMI行冠状动脉造影的497例患者，然后根据直接PCI术中是否出现血流缓慢分为两组：血流缓慢组（n = 117）和对照组（n = 380）。检测每组患者的ABG、FIB等指标，采用logistic回归分析和受试者操作特征（ROC）曲线分析直接PCI术中血流缓慢的独立危险因素，并进一步评估患者的预后。
血流缓慢患者的ABG和FIB水平显著高于对照组（P < 0.05）。多因素logistic回归分析结果提示，FIB和ABG是直接PCI术中血流缓慢的独立危险因素（均P < 0.05）。ROC曲线分析显示，ABG、FIB及其联合指标对直接PCI术中血流缓慢均有预测价值（均P < 0.05），且联合指标的曲线下面积（AUC）高于任何单一指标，差异有统计学意义（P < 0.05）。KM曲线分析提示，血流缓慢组患者的预后较差。
ABG和FIB升高均可预测直接PCI术中血流缓慢，联合指标的诊断价值优于任何单一指标，可用于评估直接PCI术中血流缓慢情况，从而评估STEMI患者的预后。
