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 |
|---|---|
| Pages (from-to) | 554-559 |
| Number of pages | 6 |
| Journal | Internal Medicine |
| Volume | 42 |
| Issue number | 7 |
| Publication status | Published - Jul 1 2003 |
| Externally published | Yes |
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Keywords
- Microcirculation
- Myocardial infarction
- ST segment
ASJC Scopus subject areas
- Internal Medicine
Cite this
Diabetes mellitus is associated with insufficient microvascular reperfusion following revascularization for anterior acute myocardial infarction. / Kurisu, Satoshi; Inoue, Ichiro; Kawagoe, Takuji; Ishihara, Masaharu; Shimatani, Yuji; Nishioka, Kenji; Umemura, Takashi; Nakamura, Suji; Yoshida, Masashi.
In: Internal Medicine, Vol. 42, No. 7, 01.07.2003, p. 554-559.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diabetes mellitus is associated with insufficient microvascular reperfusion following revascularization for anterior acute myocardial infarction
AU - Kurisu, Satoshi
AU - Inoue, Ichiro
AU - Kawagoe, Takuji
AU - Ishihara, Masaharu
AU - Shimatani, Yuji
AU - Nishioka, Kenji
AU - Umemura, Takashi
AU - Nakamura, Suji
AU - Yoshida, Masashi
PY - 2003/7/1
Y1 - 2003/7/1
N2 - 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.
AB - 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.
KW - Microcirculation
KW - Myocardial infarction
KW - ST segment
UR - http://www.scopus.com/inward/record.url?scp=0041742245&partnerID=8YFLogxK
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M3 - Article
VL - 42
SP - 554
EP - 559
JO - Internal Medicine
JF - Internal Medicine
SN - 0918-2918
IS - 7
ER -