Abstract 3466: Diabetes Mellitus and High Peak Creatine Kinase are Risk Factors of the Retinopathy Associated with Acute Myocardial Infarction
Background: The severe inflammatory reaction caused by acute myocardial infarction (AMI) and reperfusion therapy affects the heart and other remote organs. We have reported that transient retinopathy, which was characterized by soft exudates around the optic disc and became most remarkable between 1 month to 2 months after the onset of AMI, occurred in about 60% patients with AMI underwent percutaneous coronary intervention (PCI). On the other hand, no retinopathy developed in any patients with stable angina who underwent PCI. The aim of this study is to investigate on the risk factor of the retinopathy associated with AMI (RAMI).
Methods and results: We investigated 62 consecutive patients (female14, age 63+/-10) with first AMI who underwent successful PCI within 24 hours after the onset. Fundus photography was performed within 1 week and 4 weeks after the onset of AMI. Soft exudates developed in 29 patients (47%) at 4 weeks after the onset AMI and they were diagnosed as RAMI. The frequency of diabetes mellitus, hemoglobin A1c levels and peak creatine kinase concentrations were higher in the RAMI group than those in the non-RAMI group (55% vs. 21%, P=0.008, 7.0+/-2.0% vs. 5.9+/-1.4%, P=0.013, 3428+/-2210 IU/l vs. 2352+/-1652 IU/l, P=0.036, respectively), whereas there were no differences between 2 groups on other risk factors of cardiovascular disease such as age, smoking, hypertension and hypercholesterolemia. In multivariate analysis, hemoglobin A1c and peak creatine kinase concentration were the predictive factors of the occurrence of RAMI (95% confidence interval(CI) 0.41– 0.89, P=0.005, 95%CI 0.999–1.00, P=0.037, respectively).
Conclusions: Diabetes mellitus and high peak creatine kinase may be risk factors of RAMI after reperfusion therapy.