The association of acute-to-chronic glycemic ratio with no-reflow in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

Abstract

Abstract Introduction In the present study, we investigate the association of acute-to-chronic (A/C) glycemic ratio with no-reflow (NR) development in ST elevation myocardial infarction (STEMI) patients following primary percutaneous coronary intervention (PCI). Material and methods This retrospective study included 905 consecutive STEMI patients who were treated with primary PCI. The A/C glycemic ratio was determined as admission blood glucose (ABG) divided by the estimated average glucose (eAG). We evaluated two primary models (full model and reduced model).The primary outcome was the presence of NR. Results The incidence of NR was 22.7% (206 cases) in the present study. We divided the study population into three tertiles (T1, T2, and T3) based on the ABG/eAG ratio. There was a stepwise increase of the frequency of NR development from the T1 to T3 group (36 patients [12%] vs. 70 patients [23%] vs. 100 patients [33%]; respectively [p <0.001, for each group comparison]). In a full model, the ABG/eAG ratio (OR; 2.274, 95% CI; 1.587–3.26, p<0.001) was associated with NR. After the performance of a step-down backward variable selection method, the thrombus grade, the ABG/eAG ratio, the infarct-related artery diameter, and age remained in the reduced model. The ABG/eAG ratio (contributing 25.3% of the explainable outcome in the model) was one of the strong predictors of NR in the reduced model. Conclusion To the best of our knowledge, this might be the first study showing a significant relationship between the ABG/eAG ratios with NR in STEMI patients after primary PCI. Figure 1 Funding Acknowledgement Type of funding source: None