IMPACT OF RAISED GLUCOSE ON NON-DIABETIC PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION TREATED WITH PERCUTANEOUS CORONARY INTERVENTION

Main Article Content

Muhammad Irfan
Sumaiya Muhammad Iqbal Memon
Sana Mehboob
Atika Naseer
Muhammad Ishaq
Fahimullah
Kanchan Bhagia

Keywords

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Abstract

Increase glucose level is thought to significantly increase the risk of both early and late death with ST-segment elevation myocardial infarction (STEMI), especially for non-diabetic patients.


Increased plasma glucose is a common feature in the acute phase of myocardial infarction (MI), ranging from 3-71% in patients without diabetes. Moreover, when serum markers of necrosis may still be normal, plasma glucose levels are available within minutes of presentation and therefore facilitate appropriate treatment decision in a timely manner. It therefore seems likely that the categorical variable elevated admission plasma glucose would be a more powerful predictor than fasting glucose and the other elements of risk prediction markers such as elevated serum markers of myocardial infarction.In addition, patients with high admission glucose are more likely to develop restenosis and require repeat revascularization procedures compared with those with normal admission glucose, and are also at increased risk for repeated MI,stent thrombosis, and death,especially for non-diabetic patients although some studies showed inconsistent effects on the risk of late mortality. Conversely, the evidence linking admission glucose levels with an adverse prognosis in patients treated with primary percutaneous coronary intervention (PCI) is limited for patients with ST-segment elevation myocardial infarction (STEMI), even if PCI has been established to be significantly more effective than thrombolytic therapy. In view of the development of reperfusion therapy, it is uncertain if elevated admission glucose remains an independent determinant of early and late mortality in patients without previously diagnosed diabetes mellitus (DM).

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