The Relationship between Admission HbA1c Level and Infarct-Related Artery Patency in ST Elevation Myocardial Infarction Patients

Abstract

Objective: Patency of infarct-related artery (IRA) in patients with ST segment elevation myocardial infarction (STEMI) before pri-mary percutaneous coronary intervention (pPCI) is associated with lower mortality and better clinical outcome. This study aimed to investigate the relationship between admission hemoglobin A1c (HbA1c) and IRA patency before mechanical reperfusion in patients with STEMI.Methods: A total of 140 consecutive patients with STEMI undergoing pPCI within 12 h from symptom onset were retrospectively evaluated. The IRA patency was assessed by the thrombolysis in myocardial infarction (TIMI) flow grade. Patients were initially di-vided into two groups based on the TIMI flow grade. Impaired flow was defined as TIMI grades 0 and 1, and normal flow or patency was defined as TIMI 2 and 3. Patients were divided into three groups based on admission HbA1c levels as group I (HbA1c ≤ 5.6%), group II (HbA1c 5.6%–6.5%), and group III (HbA1c ≥ 6.5%).Results: Among 140 patients, 46 (32.8%) had pre-pPCI TIMI 2 and 3 flow in IRA. The IRA patency was found to be similar in all three HbA1c groups (p=0.269). Admission HbA1c levels were similar in both IRA groups (p=0.314). In multivariate regression analysis, only MPV (OR:0.589, 95%CI:0.365–0.951, p=0.030) was significantly and independently associated with IRA patency.Conclusion: HbA1c is not an independent predictor of the IRA patency in patients with STEMI treated with pPCI. However, MPV is a simple, low-cost, and easily accessible parameter and might be used as a predictor of IRA patency.