Rendom Cotrol Study of Peri-operative Application of GLP-1 Analogue and Insulin on Myocardial Perfusion and Prognosis in STEMI Patients With Stress-induced Hyperglycemia
10.3969/j.issn.1000-3614.2017.05.005
- VernacularTitle:ST段抬高型心肌梗死合并应激性高血糖患者围手术期应用胰高血糖素样肽-1与胰岛素对心肌灌注及预后的影响
- Author:
Liqiang FU
;
Xinwei JIA
;
Qi ZHANG
;
Huanjun PAN
;
Chunhong CHEN
;
Shenghui LIU
;
Yugang ZU
;
Ya LI
;
Yanmin WU
;
Wenping ZHAO
- Keywords:
Myocardial infarction;
Hyperglycemia;
Glucagon-like peptidel;
Myocardial reperfusion
- From:
Chinese Circulation Journal
2017;32(5):436-441
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the peri-operative application of GLP-1 analogue and insulin on myocardial perfusion and clinical prognosis in patients of acute ST segment elevation myocardial infarction (STEMI) with stress-induced hyperglycemia. Methods: Our research was a prospective single center randomized control study. A total of 114 consecutive STEMI patients received percutaneous coronary intervention (PCI) within 12h of onset were enrolled, the patients had no diabetes while blood glucose ≥11.1mmol/L at immediate admission. Based on random number table, the patients were divided into 2 groups: Observation group, the patients received GLP-1 analogue, n=59 and Control group, the patients received insulin, n=55. The post-operative myocardial perfusion, indicators of myocardial damage and cardiac function, myocardial infarct area (MIA) and myocardial salvage index (MSI) were compared between 2 groups. The patients were followed-up for 6 months to record the incidence of major adverse cardiovascular events (MACE). Results: At peri-operative period, compared with Control group, Observation group had decreased peak values of creatine kinase isoenzyme (CK-MB) and troponin T (cTnT), P<0.05. At 6 months post-operation, compared with Control group, Observation group showed increased myocardial perfusion and left ventricular ejection fraction (LVEF), P<0.05, reduced MIA (15±12) g vs (20±14) g, P<0.05 and 12% elevated MSI as (0.64±0.13) vs (0.56±0.12), P<0.001. The MACE incidence was similar between 2 groups, P=0.217. Conclusion: In STEMI patients with stress-induced hyperglycemia, peri-operative application of GLP-1 analogue may safely regulate blood glucose, improve cardiac perfusion and function, reduce MIA; while it had no influence on myocardial perfusion at peri-operative period and no impact on MACE occurrence at 6 months post-operation.
