Vol 79, No 2 (2021)
Original article
Published online: 2020-12-31

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The association of acute­-to­-chronic glycemic ratio with no-reflow in patients with ST­-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Barış Şimşek, Tufan Çınar, Veysel Ozan, Tanık D. İnan, Gönül Zeren, İlhan İ. Avcı, Barış Güngör, Fatih Yılmaz, İbrahim H. Tanboğa, Can Y. Karabay
Pubmed: 33394580
Kardiol Pol 2021;79(2):170-178.

Abstract

Background: No‑reflow (NR) is a strong and independent predictor of poor cardiovascular outcomes among patients with ST‑segment elevation myocardial infarction (STEMI).

Aims: The aim of the study was to investigate the association of the acute‑to‑chronic (A/C) glycemic ratio with no‑reflow (NR) in STEMI patients following primary percutaneous coronary intervention (PCI).

Methods: This retrospective study included 905 patients with STEMI. The A/C glycemic ratio was determined as admission blood glucose (ABG) divided by the estimated average glucose (eAG). We evaluated 2 primary models (full model and reduced model). The primary outcome was the presence of NR.

Results: The incidence of NR was 22.7% (206 cases) in the present study. We divided the study population into 3 tertiles (T1, T2, and T3) based on the ABG/eAG ratio. There was a stepwise increase of the frequency of NR from the T1 to T3 group (36 patients [12%] vs 70 patients [23%] vs 100 patients [33%]; respectively [P < 0.001, for each group comparison]). In a full model, the ABG/eAG ratio (OR, 2.274; 95% CI, 1.587–3.26; P < 0.001) was associated with NR. After the performance of a step-down backward variable selection method, the thrombus grade, the ABG/eAG ratio, the infarct‑related artery diameter, and age remained in the reduced model. The ABG/eAG ratio (contributing 25.3% of the explainable outcome in the model) was one of the strong predictors of NR in the reduced model.

Conclusions: To our knowledge, this might be the first study showing a significant relationship between the ABG/eAG ratios with NR in patients with STEMI after primary PCI.

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Polish Heart Journal (Kardiologia Polska)