الفهرس | Only 14 pages are availabe for public view |
Abstract This study addressed the relationships between admission random blood glucose (RBG), fasting blood glucose (FBG), and severity of coronary artery disease ―assessed by Gensini score ―and In hospital outcomes in patient admitted with ST elevated Myocardial Infarction (STEMI). The study was conducted on 100 patients who were recruited from Cardiology department in Tanta University presented with ST segment elevation acute myocardial infarction and underwent coronary angiography either primary PCI or Pharmaco-invasive, the patients were divided firstly, According to Random Blood Glucose (RBG) into two groups: group 1: Non hyperglycemia group (<200 mg/dl) group 2: Hyperglycemia group (>200 mg/dl) Then after 8hours from admission fasting blood glucose (FBG) was tested ”regarding FBG Patient is fasting but to be well hydrated” and accordingly the patients were divided into two groups: group I: Non-FBG elevated (<126 mg/dl) group II: FBG elevated (>126 mg/dl). It was shown that there was a significant difference between the hyperglycemic and FBG elevated groups in terms of severity of coronary artery disease and In-hospital mortality where both the hyperglycemic and the FBG elevated patients had more extensive coronary artery disease and a higher Gensini score. Also, the occurrence of major adverse cardiovascular events was higher in these two groups in comparison to their nonhyperglycemic, non FBG elevated counterparts. On further analysis, those patients with deranged glycometabolism presented later from onset of symptoms with more adverse presentation at first medical contact, had a larger infarct size and worse Final TIMI flow post intervention. Subsequently, they suffered more complications during their hospital stay suffering more from cardiogenic shock, congestive heart failure, new onset arrythmias, CIN and stroke. All of this turbulent course lead higher In-hospital mortality in hyperglycemic and FBG elevated Group. |