Objectives
Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one.
We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR).
Methods
We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR.
Results
AH showed significant positive correlations to FIS (r value = 0.538, P = < 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI.
Conclusion
Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.