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.
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.
Authors: Kamran Ahmed Khan; Rajesh Kumar; Jehangir Ali Shah; Fawad Farooq; Quratulain Shaikh; Dileep Kumar; Jawaid Akbar Sial; Tahir Saghir; Abdul Samad Achakzai; Musa Karim Journal: SAGE Open Med Date: 2022-03-31