Impact of hypoglycemic regimens on cardiac recovery and quality of life after PCI in elderly AMI patients.

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.