The American journal of the medical sciences · 2021
ST-Elevation Myocardial Infarction Patients with Hyperglycemia: Effects of Intravenous Adenosine.
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Mone Pasquale, Pansini Antonella, Rizzo Mario, Minicucci Fabio, Mauro Ciro
Аннотация
BACKGROUND: Admission hyperglycemia is common in subjects with acute myocardial infarction (AMI). Reperfusion therapy with primary percutaneous coronary intervention (PPCI) represents the leading therapeutic choice, in particular in ST-segment elevation myocardial infarction (STEMI). Despite this, mortality, re-hospitalizations and complications remain a relevant problem. Adenosine, a purine nucleoside, may reduce no-reflow. Therefore, whe studied the effects of intravenous infusion of adenosine in addition to primary percutaneous coronary intervention (PPCI) in hyperglycemic patients with STEMI.
METHODS: We evaluated 836 patients with STEMI and admission hyperglycemia (glycemia >140 mg/dL). At the end, 399 patients were entered into the database. Patients were grouped on the basis of whether they received adenosine or not.
RESULTS: A total of 199 patients received intravenous adenosine infusion and PPCI and 200 patients did not. Kaplan-Meier analysis demonstrated significant differences in all death, cardiac death, re-hospitalization for heart failure and for acute coronary syndrome in the adenosine treated group.
CONCLUSIONS: The effects of intravenous infusion of adenosine and PPCI on clinical outcomes are significant but we need future larger studies with larger follow-up and statistical analysis to confirm our results.
METHODS: We evaluated 836 patients with STEMI and admission hyperglycemia (glycemia >140 mg/dL). At the end, 399 patients were entered into the database. Patients were grouped on the basis of whether they received adenosine or not.
RESULTS: A total of 199 patients received intravenous adenosine infusion and PPCI and 200 patients did not. Kaplan-Meier analysis demonstrated significant differences in all death, cardiac death, re-hospitalization for heart failure and for acute coronary syndrome in the adenosine treated group.
CONCLUSIONS: The effects of intravenous infusion of adenosine and PPCI on clinical outcomes are significant but we need future larger studies with larger follow-up and statistical analysis to confirm our results.