| BackgroundIn the past few decades,the management of patients with acute ST-segment elevation myocardial infarction has made great progress.Both domestic and foreign guidelines indicate that percutaneous coronary intervention（PCI） is the main means of reperfusion therapy for STEMI,which can significantly improve the prognosis and reduce the mortality of STEMI patients,but the incidence of adverse cardiovascular events in STEMI patients is still high.Hyperglycemia was also associated with an in creased risk of adverse events following hospitalization in STEMI patients,even after PCI.Therefore,this study investigated the association of hyperglycemia with the incidence and prognosis of cardiovascular events in non-diabetic STEMI patients in northern Henan after PCI and within 1 year after discharge.ObjectiveThis study investigated the correlation of hyperglycemia on the incidence and prognosis of cardiovascular events in non-diabetic STEMI patients in northern Henan after PCI and within 1 year after discharge,provide reference value for clinical work.MethodsAccording to fasting blood sugar levels,317 non-diabetic STEMI patients receiving emergency PCI treatment,who were admitted to The Fourth Clinical College of Xinxiang Medical College（Xinxiang Central Hospital）from September 2016 to April 2018 in northern Henan,were divided into two groups:hyperglycemia group（fasting blood glucose ≥7.0mmol/L,n=115）and control group（fasting blood glucose<7.0mmol/L,n=202）.The difference of baseline data between the two groups was compared by independent sample T-test or non-parametric test;chi-square test or Fisher’s exact probability test was used to compare the difference of clinical events between the two groups;univariate and multivariate Logistic regression analyses were used to determine the risk factors influencing the study end point event,and to analyze the relationship between hyperglycemia and the incidence andprognosis of in-hospital adverse cardiovascular events in non-diabetic STEMI patients in northern Henan.Results（1）Patients in hyperglycemia group had a old age,a higher proportion of women,a higher proportion of smoking,and a higher proportion of admission Killip grade≥ II（P<0.05）.The fasting blood glucose,heart rate,alanine aminotransferase（AL T）and N-terminal B-type natriuretic peptide（NT-pro BNP）in the hyperglycemia group were higher than those in normal blood glucose group（P<0.05）.The left ventric ularejection fraction in the hyperglycemia group was significantly lower than that in normal blood glucose group（P<0.05）.（2）Compared with the normal blood glucose group,the incidence of anteriormy ocardial infarction,malignant arrhythmia and atrial fibrillation was higher in the hy perglycemia group（P<0.05）;The proportion of triple vessel disease in hyperglycemi a group was significantly higher（P<0.05）.（3）Compared with the normal blood glucose group,the number of all-cause death,cardiogenic death,cardiogenic shock,heart failure,gastrointestinal bleeding and MACE in hyperglycemia group was higher during hospitalization in this region（P<0.05）.Logistic multivariate regression analysis showed that hyperglycemia was an ind ependent risk factor for cardiogenic death and MACE during hospitalization in nondiabetic STEMI patients in this region（P<0.05）.（4）There was no significant difference in the proportion of all-cause death,heart failure,and MACE in the hyperglycemia group compared with the normoglycemi a group after discharged 1 year,and the difference was not statistically significant（P<0.05）,and indicating that hyperglycemia was not significantly associated with the incidence and prognosis of cardiovascular events within 1 year of non-diabetic STEMI patients in this region.Conclusion1.Hyperglycemia is an independent risk factor for cardiac death and MACE in STEMI patients during hospitalization.2.Hyperglycemia had no significant correlation with the incidence and prognosis of cardiovascular events within 1 year in non-diabetic STEMI patients in northern Henan. |
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