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- Title
Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA.
- Authors
Paolisso, Pasquale; Foà, Alberto; Bergamaschi, Luca; Donati, Francesco; Fabrizio, Michele; Chiti, Chiara; Angeli, Francesco; Toniolo, Sebastiano; Stefanizzi, Andrea; Armillotta, Matteo; Rucci, Paola; Iannopollo, Gianmarco; Casella, Gianni; Marrozzini, Cinzia; Galiè, Nazzareno; Pizzi, Carmine
- Abstract
Background: Hyperglycemia has been associated with increased inflammatory indexes and larger infarct sizes in patients with obstructive acute myocardial infarction (obs-AMI). In contrast, no studies have explored these correlations in non-obstructive acute myocardial infarction (MINOCA). We investigated the relationship between hyperglycemia, inflammation and infarct size in a cohort of AMI patients that included MINOCA. Methods: Patients with AMI undergoing coronary angiography between 2016 and 2020 were enrolled. The following inflammatory markers were evaluated: C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-platelet ratio (NPR). Myocardial infarct size was measured by peak high sensitivity troponin I (Hs-TnI) levels, left-ventricular-end-diastolic-volume (LVEDV) and left ventricular ejection fraction (LVEF). Results: The final study population consisted of 2450 patients with obs-AMI and 239 with MINOCA. Hyperglycemia was more prevalent among obs-AMI cases. In all hyperglycemic patients—obs-AMI and MINOCA—NLR, NPR, and LPR were markedly altered. Hyperglycemic obs-AMI subjects exhibited a higher Hs-TnI (p < 0.001), a larger LVEDV (p = 0.003) and a lower LVEF (p < 0.001) compared to normoglycemic ones. Conversely, MINOCA patients showed a trivial myocardial damage, irrespective of admission glucose levels. Conclusions: Our data confirm the association of hyperglycemic obs-AMI with elevated inflammatory markers and larger infarct sizes. MINOCA patients exhibited modest myocardial damage, regardless of admission glucose levels.
- Subjects
MYOCARDIAL infarction; HYPERGLYCEMIA; INFLAMMATION; NEUTROPHILS; VENTRICULAR ejection fraction; CORONARY angiography
- Publication
Cardiovascular Diabetology, 2021, Vol 20, Issue 1, p1
- ISSN
1475-2840
- Publication type
Article
- DOI
10.1186/s12933-021-01222-9