Hyperglycemia, inflammatory response and infarct size in obstructive acute myocardial infarction and MINOCA

Cardiovascular Diabetology

Paola Rucci¹  Francesco Angeli²  Luca Bergamaschi²  Michele Fabrizio²  Andrea Stefanizzi²  Cinzia Marrozzini²  Matteo Armillotta²  Carmine Pizzi²  Sebastiano Toniolo²  Nazzareno Galiè²  Francesco Donati²  Pasquale Paolisso²  Alberto Foಠ Chiara Chiti²  Gianni Casella³  Gianmarco Iannopollo³ 

[1] Division of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy;Unit of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy;Unit of Cardiology, Maggiore Hospital, Bologna, Italy;

关键词: Hyperglycemia;    Inflammation;    Infarct size;    MINOCA;    Obstructive acute myocardial infarction;   

DOI  :  10.1186/s12933-021-01222-9

来源: Springer

【 摘 要 】

BackgroundHyperglycemia 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.MethodsPatients 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).ResultsThe 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.ConclusionsOur 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.

【 授权许可】

CC BY