Association between Admission Hyperglycemia and Left Ventricular Function in ST-Segment Elevation Myocardial Infarction Patients undergoing Primary Coronary Intervention

Background: Admission hyperglycemia as well as echocardiographic parameters of diastolic dysfunction are associated with worse outcomes in patients presenting with ST segment elevation myocardial infarction (STEMI). We evaluated the relation between admission serum hyperglycemia and left ventricular (LV) function in STEMI patients who underwent successful reperfusion with primary percutaneous coronary intervention (PCI)

Methods: We conducted a retrospective, single center observational study including 291 consecutive STEMI patients treated with primary PCI. The baseline demographic, clinical, echocardiographic and angiographic features test results were retrieved from medical files and the hospital database. Patients were divided into two groups according to their admission glucose (normoglycemic < 140mg/dl, and hyperglycemic ≥ 140mg/dl)

Results: Admission hyperglycemia was associated with worse LV ejection fraction (45% ± 9 vs. 48% ± 7, P=0.024), lower septal and lateral e` (P=0.001), higher frequency of E/e` >15 (27% vs. 14%; p=0.015) and significantly higher frequency of grade 2 or 3 diastolic dysfunction (32% vs. 15%, P=0.001). In multivariate analysis admission hyperglycemia remained an independent predictor of lower LVEF (P=0.041) and lower septal e` (P=0.031), and a predictor of diastolic dysfunction (OR 2.32, 95%CI 1.27-4.23; P=0.006).

Conclusions: Admission hyperglycemia in STEMI patients undergoing primary PCI is associated with echocardiographic parameters of elevated LV filling pressure and worse diastolic function.