Abstract
Objective. The purpose of this study was to test the hypothesis that lack of microvascular reperfusion following revascularization might be associated with a poor clinical outcome in diabetic patients with acute myocardial infarction (AMI). Methods. We studied 134 patients with a first anterior AMI who underwent successful revascularization within 6 hours. We assessed microvascular reperfusion by using electrocardiogram recordings just before revascularization and on return to the coronary care unit. Lack of microvascular reperfusion was defined as the absence of decrease of ≥20% in the sum of ST segment elevation (ΣST). Results. Twenty-four patients had diabetes and 110 patients did not. ΣST before revascularization was similar between diabetic and nondiabetic patients. After revascularization, reduction of ΣST was significantly smaller (1.3±8.4 mm vs 6.5±10.8 mm, p=0.03), and lack of microvascular reperfusion was significantly more frequent (62.5% vs 33.6%, p=0.01) in diabetic patients. A multivariate analysis showed that diabetes was associated with insufficient microvascular reperfusion (odds ratio 3.18, p=0.03). Major adverse cardiac events occurred more frequently in patients with a lack of microvascular reperfusion (30.8% vs 15.9%, p=0.04). Conclusion. These findings suggest that lack of microvascular reperfusion following revascularization may be one of the mechanisms of a poor clinical outcome in diabetic patients with AMI.
Original language | English |
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Pages (from-to) | 554-559 |
Number of pages | 6 |
Journal | Internal Medicine |
Volume | 42 |
Issue number | 7 |
DOIs | |
Publication status | Published - Jul 1 2003 |
Externally published | Yes |
Keywords
- Microcirculation
- Myocardial infarction
- ST segment
ASJC Scopus subject areas
- Internal Medicine