The Relationship between Elevated Pre-procedural Random Blood Glucose Level and Periprocedural Myocardial Injury in Patients Undergoing Elective Percutaneous Coronary Intervention

Abstract

Background Regardless of the diabetic status of patients with coronary artery disease, both hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. Numerous studies have concluded that hyperglycemia is common in diabetic and non-diabetic patients with STelevation myocardial infarction (STEMI) and is associated with a higher risk of death and in-hospital complications. Aim and Objectives The aim of this study is to assess the relationship between elevated preprocedural random blood glucose level and peri-procedural myocardial injury in patients undergoing elective percutaneous coronary intervention. Patients and Methods This Cohort study included 110 patients who presented with chronic coronary syndrome to the cardiology department of Ain Shams university hospitals and underwent elective PCI. They were divided into 2 equal groups, 55 as hyperglycemic group and 55 as euglycemic group. Blood glucose level was measured immediately before the procedure. Blood samples for cardiac troponin (I) were obtained before the procedure and 12 hours after the procedure. Results There was statistically significant difference between the two groups regarding incidence of both myocardial infarction and myocardial injury, both being higher among the hyperglycemic group (P-value: 0.022) &(P-value: 0.001) respectively. All five patients who had myocardial infarction belonged to the hyperglycemic group. 23 patients with myocardial injury belonged to the hyperglycemic group while only 7 patients with myocardial injury belonged to the euglycemic group. Conclusion We conclude that abnormally high pre-procedural plasma glucose levels in patients undergoing coronary angioplasty are associated with an increased incidence of peri-procedural myocardial injury and infarction in patients undergoing elective PCI.