Abstract 13030: Hyperglycemia Drives In-Stent Restenosis in STEMI Patients

Abstract

Introduction: Hyperglycemia (HG) has been shown to adversely affect the outcome of ST-elevation myocardial infarction (STEMI). Hypothesis: We hypothesized that HG at hospital admission could increase the risk of in-stent restenosis after primary percutaneous coronary intervention (PCI) for STEMI. Methods: We enrolled consecutive STEMI patients referred to the division of Cardiology of "Antonio Cardarelli" Hospital in Naples, comparing normoglycemic subjects ( NG ), patients without diabetes mellitus but with HG ( HG-non-DM ), and patients with both HG and DM ( HG-DM ). Results: A total of 336 propensity score matched patients were included in the study: 112 NG, 112 HG-non-DM, and 112 HG-DM. At 1-year follow-up, 6.5% of NG patients, 14.0% of HG-non-DM, and 18.5% of HG-DM had been re-hospitalized for restenosis; Kaplan-Meier curves ( p : 0.009) are depicted in the Figure . We then examined these findings applying a multivariate analysis with Cox regression in HG-non-DM patients, observing a significant association with restenosis for glycemia at hospital admission, total and LDL-cholesterol. Conclusions: The present study is the first to evaluate the effects of HG on the risk of restenosis in STEMI patients without DM, comparing the results to both HG-DM and NG subjects. Taken together, our data indicate that HG is associated with adverse outcomes in STEMI patients independently of DM. These findings emphasize the importance of glycemic control in all STEMI patients in order to reduce the risk of complications.