A Randomized Trial Of Ischemia-reperfusion Injury In Primary Percutaneous Coronary Intervention For Patients With Hyperglycemia And Euglycemia

Context: The worldwide epidemic of diabetes mellitus is increasing the burden of cardiovascular diseases including acute myocardial infarction(AMI). The independent effect of diabetes on Ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) is uncertain.Objective: To evaluate the influence of hyperglycemia on Ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI).Design and Patients: Two groups analysis of patients with diabetes and without diabetes enrolled in randomized clinical trials that evaluated the incidence of Ischemia-reperfusion injury following PCI. All patients come from the first hospital of JiLin University admission for AMI and operated primary PCI during July to Dec. in 2009, including 125 patients (93 men and 32 women), of whom 20 had diabetes and others without.A multivariable model was constructed to adjust for baseline characteristics, aspects of gender, age, hypertension, smoking,fasting glycaemia and blood-fat. A subgroup analysis of patients with fasting glycaemia less than 6mmol/L, during 6 mmol/L~7 mmol/L (including 6 mmol/L) and more than 7 mmol/L (including 7 mmol/L) in randomized clinical trials that evaluated the incidence of Ischemia-reperfusion injury following PCI.Main Outcome Measures: Incidence of Ischemia-reperfusion injury following primary PCI among patients with diabetes vs patients without diabetes and patients with fasting glycaemia less than 6mmol/L vs more than 6 mmol/L.Results: Female was significantly higher among patients with diabetes than without diabetes (55% vs 20%, P<0.005) and as well as FG . Patients with diabetes and smoking or hypertension was less than patients without diabetes. Without adjusting for baseline characteristics. Incidence of Ischemia-reperfusion injury following primary PCI at 2 hours was as similar as among patients with diabetes and without diabetes (35% vs 36%, P>0.05). Among subgroups, Incidence of tachyarrhythmia was significantly higher among patients with FG between 6 mmol/L and 7 mmol/L (including 6 mmol/L) than less than 6mmol/L (33.33% vs 13.51%, P<0.05). With FG increasing, the incidence of tachyarrhythmia tendency to increase.Conclusion: Incidence of Ischemia-reperfusion injury following primary PCI at 2 hours was not association with diabetes,but hyperglycemia. Incidence of tachyarrhythmia was significantly rising among patients with FG more than 6 mmol/L;Diabetes was more important for women who would be acute myocardial infarction.