Effect of diabetes on scintigraphic infarct size in STEMI patients undergoing primary angioplasty.

Abstract

BACKGROUND:

It has been shown that among patients with ST-segment elevation myocardial infarction (STEMI), diabetes is associated with a significantly higher mortality, mainly because of impaired reperfusion. However, few data have been reported so far on infarct size as evaluated by well-refined techniques, such as nuclear imaging techniques. Therefore, the aim of the current study was to investigate the effect of diabetes in infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI.

METHODS:

We included 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99 m-sestamibi. A logistic regression analysis was performed to determine the relation between diabetes and infarct size (as above the median) after correction for baseline confounding factors.

RESULTS:

A total of 115 (13.8%) out of 830 patients suffered from diabetes. Diabetic patients were older (p < 0.001), with larger prevalence of female gender (p = 0.006) and hypertension (p = 0.001) but were less often smokers (p = 0.003). Diabetic patients had more often preprocedural thrombolysis in myocardial infarction grade 3 flow (p = 0.034) and less complete ST-segment resolution (p = 0.009). No difference was observed in scintigraphic infarct size between diabetes and control patients (p = 0.6)), which was confirmed at multivariate analysis after correction for baseline confounding factors (Adjusted OR [95% CI] = 0.87 [0.57-1.31, p = 0.51).

CONCLUSION:

Our study showed that among STEMI patients undergoing primary angioplasty, diabetes did not affect infarct size as compared with non-diabetic patients.

• Authors: Giuseppe De Luca, Guido Parodi, Roberto Sciagrà, Benedetta Bellandi, Ruben Vergara, Angela Migliorini, Renato Valenti, David Antoniucci
• Journal: Diabetes/metabolism research and reviews (Diabetes Metab Res Rev) Vol. 31 Issue 3 Pg. 322-8 (Mar 2015) ISSN: 1520-7560 [Electronic] England
• PMID: 25382676 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2014 John Wiley & Sons, Ltd.

Topics

• Aged
• Angioplasty
• Case-Control Studies
• Cohort Studies
• Diabetes Mellitus (physiopathology)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, pathology, surgery)
• Myocardial Perfusion Imaging (methods)
• Prognosis