Coronary microcirculation and short-term prognosis in patients with type 2 diabetes and poor glucose controls who underwent elective percutaneous coronary intervention for acute myocardial infarction
10.3969/j.issn.1004-8812.2017.11.005
- VernacularTitle:2型糖尿病血糖控制不良合并急性心肌梗死患者择期经皮冠状动脉介入治疗后冠状动脉微循环及近期预后
- Author:
mei Meng LI
1
;
bing Yi SHAO
;
quan Chun ZHANG
;
hao Yu LIU
;
Yue WU
;
Xu WANG
Author Information
1. 青岛大学附属青岛市市立医院心内科
- Keywords:
Diabetes;
Index of microcirculatory resistance;
Percutaneous coronary intervention;
Microcirculation;
Prognosis;
Myocardial infarction
- From:
Chinese Journal of Interventional Cardiology
2017;25(11):628-633
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the status of microcirculation and to compare the short-term prognosis after elective PCI for AMI between patients with poorly controlled type2 diabetes and patients without type 2 diabetes. Methods According to the clinical history and HbA1c values,all patients were divided into 2 groups:diabetic group (group A,n=24) and non-diabetic group (group B,n=32).Basic clinical data, left ventricular end diastolic diameter (LVEDD) and left ventricular shot ejection fraction (LVEF)immediately and 3 months after operation measured by echocardiography and the result of coronary angiography were compared between the two groups. The rate of MACE 3 months after PCI was also compared. A pressure-temperature sensor wire was used to measure the index of microcirculation resistance(IMR)immediately after PCI. Results 1.The mean IMR value in group A was higher than group B(29.12±7.45)vs.(22.74±6.87);P=0.011.The HbA1c levels has positive correlation with the IMR value(r=0.324;P=0.048). 2. The mean LVEDD and the mean LVEF Rad no signifi cant diff erence between two groups before PCI. The mean LVEDD of group A at 3 months after PCI was significantly larger than group B(52.3±4.8)mm vs.(48.6±5.1)mm,P=0.019,the mean LVEF of group A 3 months post PCI was lower than that of group B(48.6±7.3)% vs.(56.1±4.7)%,P=0.003.The mean increase in LVEDD at 3 months after PCI in group A was higher than group B(4.1±6.3)mm vs.(0.8±4.4)mm, p=0.005 and the mean increase in LVEF in group A was significantly lower than in group B(–1.9±6.8)% vs. (4.3±5.4)%,P=0.007. 3. HbA1chad positive correlation with LVEDD(r=0.324,p=0.048)and its increase at 3 months postoperatively(r=–0.422,P=0.005).4. Risk estimation found type 2 diabetes was an independent risk factor for poor recovery of LVEF. The MACE rate was signifi cantly higher in Group A than in Group B(35.7% vs.9.4%,P=0.018).Conclusions Patients with type2 diabetes were more prone to suffer from coronary microcirculatory dysfunction and had poor recovery of cardiac function. Poorly controlled type 2 diabetes was an independent risk factor for poor recovery of cardiac function and short-term prognosis was worse in diabetic patients who had elective PCI.
