PMID- 18813179
OWN - NLM
STAT- MEDLINE
DCOM- 20090126
LR  - 20101118
IS  - 0026-4725 (Print)
IS  - 0026-4725 (Linking)
VI  - 56
IP  - 5
DP  - 2008 Oct
TI  - Admission glycemia and markers of inflammation are independent outcome predictors 
      in primary PCI in non-diabetic patients.
PG  - 445-52
AB  - AIM: To assess the prognostic value of admission plasma glucose (APG) respect to 
      clinical variables and inflammatory markers in a selected population of 
      non-diabetic patients with ST elevation myocardial infarction (STEMI) treated 
      with primary angioplasty (primary coronary intervention, PCI). METHODS: A total 
      of 188 consecutive non-diabetic STEMI patients undergoing primary PCI were 
      divided into four quartiles based on APG (<117, 117-140, 141-170, >170 mg/dL). 
      Combined end-point of major adverse cardiac events (MACE) was defined as death, 
      acute heart failure, re-infarction, unstable angina or inducible ischemia. 
      RESULTS: Event-free survival from MACE was significantly (P<0.001) correlated 
      with APG quartiles and decrease from the lowest to the highest: 6 months 
      event-free survival was 89.3%, 77.4%, 59.1%, 42.5%. Patients with higher APG were 
      characterized by a significantly higher Killip class (P<0.001), higher serum 
      creatinine (P<0.05) on admission, and a lower rate of thrombolysis in myocardial 
      infarction (TIMI) 3 flow after PCI (P<0.05). Multivariate analysis showed APG>170 
      mg/dL (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.24 to 4.65, 
      P<0.01), admission high-sensitivity C-reactive protein level (HR 1.19, 95% CI 
      1.07 to 1.31, P<0.001), white blood cells count (HR 1.07, 95% CI 1.00 to 1.14, 
      P<0.04) and heart rate (HR 1.02, 95% CI 1.00 to 1.04, P<0.02) to be independent 
      predictors of MACE. CONCLUSION: Admission glycemia and inflammatory markers are 
      independent predictors of MACE in the mid-term follow-up in non-diabetic STEMI 
      treated with primary PCI. Further investigations are needed to study the 
      pathogenesis of stress hyperglycaemia, interactions with mechanisms of 
      inflammation and whether early and aggressive treatment with insulin may 
      influence outcome of primary PCI.
FAU - Corrada, E
AU  - Corrada E
AD  - Unit of Hemodynamics, Invasive Cardiology and Coronary Care, Humanitas Clinical 
      Institute, Milan, Italy. elena.corrada@fastwebnet.it
FAU - Cappelleri, A
AU  - Cappelleri A
FAU - Belli, G
AU  - Belli G
FAU - Genovese, S
AU  - Genovese S
FAU - Barbaro, C
AU  - Barbaro C
FAU - Gasparini, G
AU  - Gasparini G
FAU - Pagnotta, P
AU  - Pagnotta P
FAU - Rossi, M
AU  - Rossi M
FAU - Zavalloni, D
AU  - Zavalloni D
FAU - Presbitero, P
AU  - Presbitero P
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Blood Glucose/*analysis
MH  - Female
MH  - Humans
MH  - Inflammation/blood
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/*therapy
MH  - Patient Admission
MH  - Predictive Value of Tests
MH  - Prognosis
EDAT- 2008/09/25 09:00
MHDA- 2009/01/27 09:00
CRDT- 2008/09/25 09:00
PHST- 2008/09/25 09:00 [pubmed]
PHST- 2009/01/27 09:00 [medline]
PHST- 2008/09/25 09:00 [entrez]
PST - ppublish
SO  - Minerva Cardioangiol. 2008 Oct;56(5):445-52.