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Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI.

Publication ,  Journal Article
Dharma, S; Mahavira, A; Haryono, N; Sukmawan, R; Dakota, I; Siswanto, BB; Rao, SV
Published in: Int J Angiol
September 2019

The association of hyperglycemia at admission and final thrombolysis in myocardial infarction (TIMI) flow with 1-year mortality of patient with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) has not much been explored. We evaluated the association of hyperglycemia and final TIMI flow with 1-year mortality in patients with acute STEMI who underwent primary PCI. We retrospectively analyzed 856 patients with STEMI who underwent primary PCI in a tertiary care academic center between January 2014 and July 2016. Based on the receiver operating characteristics curve, the cutoff used for hyperglycemia in this study was greater than or equal to 169 mg/dL. Cox proportional hazard model was used to determine the association of hyperglycemia and TIMI flow with 1-year mortality. Compared with patients with lower blood glucose level (<169 mg/dL; n  = 549), a greater proportion of patients who presented with hyperglycemia (≥169 mg/dL; n  = 307) had final TIMI flow 0 to 1 (3.3 vs. 0.5%; adjusted odds ratio = 5.58, 95% confidence interval [CI] 1.30-23.9, p  = 0.02). Hyperglycemia was associated with an increased risk for 1-year mortality (adjusted hazard ratio [HR]= 2.0, 95% CI: 1.13-3.53, p  = 0.017). Multivariable Cox regression showed that the interaction of hyperglycemia and final TIMI flow 0 to 1 was associated with an elevated risk for 1-year mortality (adjusted HR= 9.4, 95% CI: 2.34-37.81, p  = 0.002). A higher proportion of patients with acute STEMI who presented with hyperglycemia had final TIMI flow 0 to 1 after primary PCI. The interaction of hyperglycemia and final TIMI flow 0 to 1 was associated with an increased risk for 1-year mortality. This study suggests that aggressive control of hyperglycemia prior to primary PCI may facilitate better angiographic and clinical outcomes after primary PCI. Clinical Trial Registration  Clinicaltrials.gov Identifier number: NCT02319473.

Duke Scholars

Published In

Int J Angiol

DOI

ISSN

1061-1711

Publication Date

September 2019

Volume

28

Issue

3

Start / End Page

182 / 187

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology
 

Citation

APA
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MLA
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Dharma, S., Mahavira, A., Haryono, N., Sukmawan, R., Dakota, I., Siswanto, B. B., & Rao, S. V. (2019). Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI. Int J Angiol, 28(3), 182–187. https://doi.org/10.1055/s-0039-1691811
Dharma, Surya, Andi Mahavira, Nur Haryono, Renan Sukmawan, Iwan Dakota, Bambang B. Siswanto, and Sunil V. Rao. “Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI.Int J Angiol 28, no. 3 (September 2019): 182–87. https://doi.org/10.1055/s-0039-1691811.
Dharma S, Mahavira A, Haryono N, Sukmawan R, Dakota I, Siswanto BB, et al. Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI. Int J Angiol. 2019 Sep;28(3):182–7.
Dharma, Surya, et al. “Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI.Int J Angiol, vol. 28, no. 3, Sept. 2019, pp. 182–87. Pubmed, doi:10.1055/s-0039-1691811.
Dharma S, Mahavira A, Haryono N, Sukmawan R, Dakota I, Siswanto BB, Rao SV. Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI. Int J Angiol. 2019 Sep;28(3):182–187.
Journal cover image

Published In

Int J Angiol

DOI

ISSN

1061-1711

Publication Date

September 2019

Volume

28

Issue

3

Start / End Page

182 / 187

Location

United States

Related Subject Headings

  • Cardiovascular System & Hematology