Frontiers in cardiovascular medicine · 2026
Impact of hypoglycemic regimens on cardiac recovery and quality of life after PCI in elderly AMI patients.
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Qian Lei, Zhou Ping, Zhao Zhimin
Аннотация
OBJECTIVE: To investigate the impact of blood glucose control levels on cardiac function recovery and long-term prognosis in elderly patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).
METHOD: A retrospective study included 80 elderly AMI patients from January 2023 to January 2024, divided into good (HbA1c ≤ 7%, n = 39) and poor (HbA1c > 7%, n = 41) baseline glucose control groups. Further, based on HbA1c at 3 months post-PCI, patients were classified into four groups: continuous good control (n = 34), postoperative improvement (n = 15), postoperative deterioration (n = 5), and persistent poor control (n = 26). Outcomes compared included MACE, stent thrombosis, cardiovascular readmission, NYHA class improvement, eGFR decline >20%, LVEF, and quality of life scores. Patients were prospectively followed at 3, 6, and 12 months after PCI via standardized telephone interviews or in-person outpatient visits to assess glycemic control (HbA1c, fasting glucose), cardiac function (LVEF, NYHA class), MACE, renal function, and quality of life (SF-36).
RESULT: The poor baseline control group had higher diabetes prevalence (78.05% vs. 20.51%, P < 0.001) and more frequent use of metformin and insulin. Group 4 had the highest MACE incidence (34.62%), lowest mean LVEF (45.3 ± 6.1%), worst renal function preservation, and lowest quality of life. Group 3 showed increased MACE risk (20%). In contrast, Group 2, achieving glucose control postoperatively, had a prognosis similar to Group 1.
CONCLUSION: Continuous blood glucose management after PCI significantly improves prognosis in elderly AMI patients. Dynamic monitoring provides greater clinical value than baseline control alone.
METHOD: A retrospective study included 80 elderly AMI patients from January 2023 to January 2024, divided into good (HbA1c ≤ 7%, n = 39) and poor (HbA1c > 7%, n = 41) baseline glucose control groups. Further, based on HbA1c at 3 months post-PCI, patients were classified into four groups: continuous good control (n = 34), postoperative improvement (n = 15), postoperative deterioration (n = 5), and persistent poor control (n = 26). Outcomes compared included MACE, stent thrombosis, cardiovascular readmission, NYHA class improvement, eGFR decline >20%, LVEF, and quality of life scores. Patients were prospectively followed at 3, 6, and 12 months after PCI via standardized telephone interviews or in-person outpatient visits to assess glycemic control (HbA1c, fasting glucose), cardiac function (LVEF, NYHA class), MACE, renal function, and quality of life (SF-36).
RESULT: The poor baseline control group had higher diabetes prevalence (78.05% vs. 20.51%, P < 0.001) and more frequent use of metformin and insulin. Group 4 had the highest MACE incidence (34.62%), lowest mean LVEF (45.3 ± 6.1%), worst renal function preservation, and lowest quality of life. Group 3 showed increased MACE risk (20%). In contrast, Group 2, achieving glucose control postoperatively, had a prognosis similar to Group 1.
CONCLUSION: Continuous blood glucose management after PCI significantly improves prognosis in elderly AMI patients. Dynamic monitoring provides greater clinical value than baseline control alone.