Evaluation of Myocardial Damage in Relation to HbA1c in Patients with Previously Unrecognized Diabetes Presenting with STEMI

Öz

Objective: The mechanisms underlying worse clinical outcomes in previously unrecognized diabetic (DM) patients in ST-elevation myocardial infarction (STEMI) are unclear. It was hypothesized that poor chronic glucose control might be related to greater myocardial damage. Material and Method: 51 newly diagnosed DM patients with glycated hemoglobin A1c (HbA1c) > 6.5 comprised the DM group, 54 sex- and age-matched individuals with normal glucose metabolism served as the non-DM group. Each patient underwent primary angioplasty for STEMI. The levels of cardiac specific markers before angioplasty, during angioplasty, at 6, 12, and 18 h after angioplasty were recorded. SPSS 10 package program was used to analyse data. Results: In both DM and non-DM groups troponin peaked at 6 h. Peak troponin levels were similar in both groups (diabetics, 22.89 ± 18.19 vs. non-diabetics, 32.67 ± 17.68 ng/ml, p=0.168). Conclusions: HbA1c > 6.5 is not related to extent of infarction in previously unrecognized DM patients presenting with STEMI. Future studies assessing the effects of other factors unrelated to chronic glucose control on myocardial damage and cardiovascular event rates in these patients would be of great interest.

Anahtar Kelimeler

• Acute coronary syndrome
• Cardiac markers
• diabetes mellitus
• Acute ST-segment elevation myocardial infarction
• Coronary angioplasty

STEMI ile Başvuran Önceden Tanı Almamış Diyabetli Hastalarda HbA1c ile İlişkili Miyokard Hasarının Değerlendirilmesi

Öz

Amaç: Daha önce tanısı konulmamış diyabetik hastalarda ST elevasyonlu miyokard enfarktüsünde (STEMI) kötü klinik sonuçların altında yatan mekanizmalar belirsizdir. Kötü glisemik kontrolün daha büyük miyokard hasarı ile ilişkili olabileceği hipotezi oluşturulmuştur. Gereç ve Yöntem: Glikolize hemoglobin A1c (HbA1c)> 6.5 olan yeni tanı konmuş 51 DM hastası DM grubunu, normal glikoz metabolizması olan 54 cinsiyet ve yaş eşleşmeli birey DM olmayan grup olarak çalışmaya dahil edildi. Her hastaya STEMI için primer anjiyoplasti yapıldı. Anjiyoplasti öncesi, anjiyoplasti sırasında, anjiyoplastiden 6, 12 ve 18 saat sonra kardiyak spesifik belirteç seviyeleri kaydedildi. Veriler SPSS 10 paket program eşliğinde analiz edildi. Bulgular: Hem DM hem de DM olmayan gruplarda troponin 6. saatte zirve yaptı. Pik troponin düzeyleri her iki grupta da benzerdi (diyabetliler, 22.89 ± 18.19 ve nondiyabetikler, 32.67 ± 17.68 ng / ml, p = 0.168). Sonuç: HbA1c’nin 6,5’tan büyük olması, STEMI ile başvuran ve daha önce DM tanısı olmayan hastalarda infarkt alanının genişliği bakımından fark bulunmamıştır. Bu hastalarda miyokard hasarı ve kardiyovasküler olay oranlarını etkileyecek kronik glikoz kontrolü dışında faktörleri değerlendirmek için gelecek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Akut koroner sendrom
• kardiyak belirteçler
• diabetes mellitus
• Akut ST segment elevasyonlu miyokard infarktüsü
• Koroner anjiyoplasti

Kaynakça

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