Effect of stress hyperglycaemia on monocyte chemoattractant protein‑1 levels and the short‑term prognosis of patients with acute ST‑segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

The present study prospectively investigated the effect of blood glucose level at admission on monocyte chemoattractant protein-1 levels at different time points before and after primary percutaneous coronary intervention, and the postoperative 1-year prognosis of patients with acute ST-segment elevation myocardial infarction. The 146 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention were divided into three groups: Group 1, non-diabetic, non-hyperglycemic group; group 2, stress hyperglycemia group; and group 3, diabetic group. Serum monocyte chemoattractant protein-1 levels before and after percutaneous coronary intervention (PCI), and the incidence of major adverse cardiovascular events 1-year post PCI were observed. The increase in monocyte chemoattractant protein-1 levels 24 h after percutaneous coronary intervention, compared with those before percutaneous coronary intervention, was significantly correlated with the blood glucose level at admission. Furthermore, the 1-year postoperative major adverse cardiovascular events rates were significantly higher in groups 2 and 3 compared with group 1. Logistic regression analysis demonstrated that a high blood glucose level at admission, diabetes, and high preoperative monocyte chemoattractant protein-1 levels were risk factors for major adverse cardiovascular events 1-year post-percutaneous coronary intervention. Stress hyperglycemia and diabetes may contribute to high monocyte chemoattractant protein-1 levels and prolonged inflammation. These symptoms are associated with poor prognosis of acute ST-segment elevation myocardial infarction in patients undergoing primary percutaneous coronary intervention.

Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy: a meta-analysis

“…[4] The adverse eff ects of secondary hyperglycemia might provide a considerable explanation for this discrepancy. [31] The original intention was to strengthen the metabolic strategy of high-dose GIK infusion; [32] however, this oversupply of glucose can contribute to a higher occurrence of hyperglycemia. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines recommend glucose control in patients with ACS and linked stress hyperglycemia to a poor prognosis in patients with AMI.…”

The association between glucose-related variables and plaque morphology in patients with ST-segment elevated myocardial infarction

“…An elevated ARPG level not only disturbed glucose metabolism that worsens the prognosis, but also accompanied by elevated stress hormone and reflected acute stress state [ 30 , 31 ]. Stress hyperglycaemia with myocardial infarction is associated with a poor prognosis in DM and nondiabetic patients [ 32 , 33 ] via disturbing myocardial blood flow and energetics, contributing to high monocyte chemo-attractant protein-1 levels and sFas apoptosis levels [ 34 , 35 ], inducing a pro-oxidative/pro-inflammatory state [ 36 , 37 ], and resulting in coronary plaque rupture eventually [ 38 ]. It might partly explain why the patients with AH continue to have a higher mortality even after rapid revascularization and treatment of hyperglycaemia [ 18 ].…”

Association of the cytokine profile and metabolic syndrome components in young patients

“…Нами установлена ассоциация МСР-1 с компонентами МС -уровнем глюкозы, триглицеридов, маркерами инсулинорезистентности Тг/ЛПВП и TyG, а также с маркером дисфункции висцеральной жировой ткани VAI. В других исследованиях доказана взаимосвязь повышения содержания МСР-1 и нарушения метаболизма глюкозы [3,11].…”