The Impact Stress Hyperglycemia On Acute Coronary Syndrome After Primary Percutaneous Coronary Intervention For Four Years

The impact of stress hyperglycemia on acute cardial infarction after primary percutaneous coronary intervention for four yearsObjective To investigate the impact of stress hyperglycemia on acute myocardial infarction who underwent primary pereutaneous coronary intervention (PCI) and the mortality and adverse cardiac events rate in these patients for four years. Analyzed the connections between the mace and the risk actors. Methods There were 491 consecutive patients with ACS who underwent primary PCI, According to the levels of the admission glucose and the history,these patients were divided into three groups:stress hyperglycemia group:158 patients fasting blood glcose=7.0mmol/l, random blood glcose=11.1mmol/l, non-diabetic.age 61.57±11.30years old,2-DM group:152 patients, fasting blood glcose=7.0mmol/l, random blood glcose=11.1mmol/l.age 62.39±9.15 years old. nomal blood glcose group:181 patients,fasting blood glcose< 6.1 mmol/1, random blood glcose< 11.1mmol/l, non-diabetic.age 61.11±9.33 years old. The three group patients underwent primary pereutaneous coronary intervention (PCI).The general clinical setting,adverse cardiac events and mortality rate in the three groups for four years were Analyzed by statistics. Results There were no significant difference in general clinical (age,male,history,smoking) setting in this data. LVEF was difference in three groups(53.46±9.44,54.82±6.97,55.68±8.41, P=0.050) stress hyperglycemia group was lower. TG was difference in three groups(2.16±1.58, 1.67±0.96,1.67±0.96, P<0.001) 2-DM group was higher.The success rate of primary percutaneous coronary intervention were similar in three groups (97.67%, 98.56%,98.39%, P>0.05). vessel lesion were significantly higher in patients with diabetic(2.71±1.33,2.36±1.17,1.82±0.98, P=0.010). B2 vessel lesion were significantly higher in patients with stress hyperglycemia glucose(58.86%,31.58 %,26.70%, P<0.001).C vessel lesion were significantly higher in patients with diabetic(46.05%,25.95%,30.11%, P<0.001). The in-hospital mortality and adverse cardiac events rate were similar in three groups.the mortality and adverse cardiac events rate in 12 months were were significantly higher in patients with higher blood glucose than in patients with 2-DM and nomal blood glucose (18.81%,11.00%,5.56%, p<0.05),the mortality and adverse cardiac events rate in 48 months were similar between the nomal blood glucose groups and higher blood glucose groups.the mortality and adverse cardiac events rate were significantly higher in patients with 2-DM in 24-48 months(26.39%,24.59%,9.70%, P<0.001). Regard mace as dependent variable, Regard age=70,blood Cr,CHO,TG,UA,WBC,LDL-C,HDL-C as independent variable did Logistic regression:In experimental group the regression coefficient of age=70years,blood Cr,WBC,LDL-C is positive, P<0.05, these were risk actor of mace;the regression coefficient of HDL-C is negative P<0.05, it was protect actor. Conclusion stress hyperglycemia, but not the diagnosis of diabetes, might contribute to predictor for 12 months mortality and adverse cardiac events rate in patients with ACS who underwent primary PCI; there were no difference mortality and adverse cardiac events rate for last period in the patients beteewn with high level of admission glucose and in patients with nomal blood glucose groups, the mortality and adverse cardiac events rate were significantly higher in patients with 2-DM in 24-48 months; age,inflammation,lower kindey function and higher LDL-C is the risk actor of mace, HDL-C is the protect actor.